Nationwide Underwriter-Pet in Brea, California
Job ID: 51419
JOB SUMMARY: Analyzes, accepts, and properly classifies applications for Nationwide Pet with established underwriting policies, practices, and standards while utilizing sound veterinary clinical judgment in order to ensure profitability. Consults with management and sales staff issues related to risks, enrollment, and regarding renewal of various policy risks.
RELATIONSHIP: Reports to Supervisor/Manager
Core Job Duties and Responsibilities:
Within established parameters, uses veterinary clinical judgment in accepting, modifying, or rejecting risks based on a review of medical reports, claims activity, file information, and nature of medical condition. Understands and adheres to rating plans.
Reviews and rates applications requiring additional evidence of insurability. Determines the need for and authorizes the ordering of clinical information, attending physician reports, claims reports, and other necessary information.
Analyzes requests for exceptions to underwriting policy and develops rationale to support the decisions made. Consults with management and sales staff regarding issues related to risks, enrollment, and renewal of various policy risks.
Conducts policy review audits to ensure compliance with Pet underwriting policies and procedures. Confirms pre-existing conditions were not overlooked; requests additional information, as needed.
Responsible for implementation/adherence of underwriting processes. Identifies gaps and makes recommendations for solutions.
Contributes to the on-going refinement and development of underwriting guidelines, policies and procedures and may communicate/train underwriting staff.
Promotes cooperative working relations in support of underwriting objectives with other functional areas (e.g., sales, customer service, Veterinary Services, etc.).
Maintains working knowledge of veterinary underwriting materials, manuals, rules, regulations, reference guides, procedures and practices pertaining to the underwriting of Pet Insurance
Performs other duties as assigned.
Education: Undergraduate degree in Biology, Zoology or related Animal Science preferred.
Experience: Typically requires 3-5 years’ experience in veterinary insurance underwriting or related insurance experience. Prefer experience working in a veterinary clinician role in a veterinary medical office or hospital.
License/Certificates: Registered/Certified Animal Health Technician. Maintenance of state mandated Continuing Education Units.
Knowledge: Professional ability that requires a working knowledge of veterinary insurance underwriting practices, principles, and procedures. In-depth understanding of veterinary medical codes, terminologies, and definitions. Proven knowledge of Pet insurance risk selection and methods for modifying risks to make them acceptable. Maintains an understanding and adheres to insurance laws and regulations related to veterinary insurance underwriting procedures. Familiar with veterinary medical service organization insurance processes.
Skills/Competencies: Effective verbal and written communication skills to respond to inquiries or complaints from fellow Pet employees, policyholders, regulatory agencies or members of the veterinary community. Proven ability to understand and interpret medical records and supporting clinical documentation (i.e. written, oral, diagram, or schedule form, etc.). Demonstrated ability to read, analyze, and interpret veterinary medical, scientific and technical journals, financial reports and insurance policy contract language. Ability to deal with a variety of variables in situations where only limited information exists. Interpersonal skills to work collaboratively with cross-functional teams (i.e. sales, customer service, Veterinary Services, etc.) and physicians, hospitals, regulatory agencies, etc. Ability to use personal computer and related medical management and business software. Ability to use analytical data to determine potential trends.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Staffing Exceptions to the above minimum job requirements must be approved by: Pet Executive and Human Resources.
Overtime Eligibility: Eligible (Nonexempt)
Working Conditions: Normal office environment. Extended work hours may be necessary to fulfill department service level agreements.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Job Evaluation Activity: 3/2017 BS
Job Family/Function: UND/PSV