About this role
Medical Underwriter
We are looking for qualified medical professionals with experience in health insurance, Third-Party Administrators (TPAs), or hospital operations for the position of Medical Underwriter. The candidate will evaluate medical risks, review medical records, assess applicants’ health conditions, and support underwriting decisions in accordance with company policies and underwriting guidelines.
Roles and Responsibilities
- Review medical history, health records, diagnostic reports, and other relevant medical documents to assess insurance
- risks.
- Evaluate health insurance proposals and determine the medical risk associated with applicants.
- Assess pre-existing diseases, medical conditions, and other risk factors to support underwriting decisions.
- Apply medical knowledge and underwriting guidelines to recommend acceptance, rejection, exclusions, or additional
- medical investigations, as applicable.
- Coordinate with internal teams, healthcare professionals, and relevant stakeholders for medical assessments and
- clarifications.
- Ensure accurate documentation, regulatory compliance, and adherence to company underwriting policies.
- Maintain confidentiality of medical records and customer information.
- Support timely processing of underwriting cases while maintaining accuracy and quality standards.
Educational Qualifications
- Mandatory qualification: BAMS, BHMS, or MBBS.
- Candidates must possess relevant educational certificates and marksheets.
Experience and Industry Requirements
- Candidates with relevant experience in Health Insurance or TPA organizations will be preferred.
- Candidates from hospital backgrounds must have a minimum of 3 years of relevant experience.
- Strong medical knowledge and the ability to interpret medical records are essentia
Must-have skills
- medical knowledgeinterpret medical records
Good-to-have skills
- Medical Underwriting