Medical Insurance Underwriter Career

Medical insurance underwriters evaluate the eligibility of applicants seeking a healthcare policy. They review each person's medical history, but they can also weigh factors such as age, profession, credit scores, and living situation. An underwriter accepts or denies each application. However, their job does not end with that one decision. They also have to determine the cost of the policy and add any exclusions or stipulations.

While there are no specific educational requirements for this career, most entry-level positions are open to applicants with at least a bachelor's degree. Because of the pressure and decision-making requirements, some employers may prefer applicants with a master's degree or specialized training or experience in healthcare.

It's essential to have a strong educational base in business, math, finance, or healthcare. Employers will typically offer on-the-job training, but they may require that you obtain certification or undertake continuing education classes to advance your career.

What Does a Medical Insurance Underwriter Do?

A medical insurance underwriter spends their workday gathering, analyzing, and verifying information related to health coverage applications. There are usually a few different steps to the process of assessing insurance applications.

• Analyzing insurance applicants’ information. A medical insurance underwriter evaluates critical information about applicants. In addition to their medical history, the underwriter may also look at the person’s career information and financial history.
• Assessing applicants’ health risks. All insurance underwriters assess the risk level of applicants. For health insurance underwriters, this involves looking at pre-existing conditions and medical history. This step in the process also includes verifying the applicant's information by looking at medical history or contacting healthcare providers.
  
• Using software to assess risk. Most underwriters use software to perform a risk assessment based on all the information that they collect.
  
• Making evidence-based decisions. After collecting, verifying, and analyzing the information, an underwriter decides on each application. They need to be able to explain their choices to the applicant and the provider.
  
• Monitoring terms of the coverage policy provided. Medical insurance underwriters are also responsible for reviewing the policies that they grant. This process involves looking at new health information and also assessing the payment of premiums. They can update the terms of the policy if needed.

These duties are generally similar regardless of where the medical underwriter works.

EDUCATION & BEST DEGREES

What Education Does a Medical Insurance Underwriter Need?

Applicants for entry-level medical insurance underwriter positions generally need at least a bachelor’s degree. There is no college program in insurance underwriting, so most employers seek applicants with an undergraduate degree in business administration or health information management. Some employers may consider those who previously worked in the healthcare industry and have a relevant degree or certification in their field.

Since this is a specialized sector of the insurance industry, you can consider pursuing a master's degree. For example, a master’s in healthcare administration or an MBA in healthcare management can give you the necessary skills and knowledge to progress along your career path. An advanced degree can also help you gain a better entry-level job and prepare you for a senior position later in your career. When determining the right healthcare leadership degree for you, consider your desired role.