Medical Underwriter - Secondment

Bupa Arabia

Role Overview

As a Medical Underwriter you will make decisions on Underwriting using clinical and medical risk knowledge. Ensure that all applications for membership are underwritten in a consistent and accurate manner, resulting in maximum risk protection. Make decisions on potential non-disclosure cases using clinical and medical risk knowledge and ensuring all referrals for non-disclosure receive an appropriate level of scrutiny. Ensure that all decisions are made in a consistent and accurate manner, resulting in maximum risk protection.Act as an expert point of reference on all aspects of underwriting and non-disclosure to provide clarity, consistency and guidance to all areas of the business.

What you'll do:

• Understand and assess the medical risks associated with medical conditions and the range of potential treatments and their costs.
• Ensure that all new applications for membership are underwritten in a consistent and timely manner so that they are processed within the agreed Service Level.
• Consider the business implications and customer needs associated with the medical risk assessment as appropriate to make an accurate decision.
• Take responsibility of working collaboratively with other business areas such as sales to achieve the best outcome for both the customer and the business.
• Request further medical information where necessary to process an application to join/upgrade and follow up these requests to prevent a no sale wherever possible.
• Maintain up to date knowledge of all Bupa Global products to ensure accurate assessment of risk as well as any policy changes that have an effect on medical risk.
• Act as an expert point of reference to other areas of the business within Bupa Global in relation to underwriting and medical non-disclosure.
• Carry out thorough and detailed investigation of cases referred into the team to determine whether the symptom or condition being claimed for existed prior to the customer s original date of joining Bupa Global and was not disclosed at the point of application.
• Use medical risk assessment techniques to assess the level of potential medical risk associated with a claim or a pre-authorisation request.
• Pro-actively contact medical/healthcare practitioners, members, providers, service partners and intermediaries in the most appropriate way in order to gain sufficient information to make a decision.
• Accurately maintain and update customer records on the customer management system. Ensure that records are accurately updated whenever a customer makes contact.
• Be tenacious in approach, pursuing each case to the best of our ability ensuring that we explore every appropriate angle, and gain the widest and most comprehensive view of the case before making a decision. Also ensuring all cases are dealt with in a consistent and timely manner and in line with the agreed service level.
• Record full and robust case investigation information and decision-making rationale and adhere to defined referral, escalation and decision-making standards.
• Comply with all regulatory and governance requirements including FCA and Treating Customers Fairly.
• Support the underwriting governance team in making sure the underwriting guidelines are up to date and in line with medical advancements.

What you'll bring:

• University degree in a medicinal field.
• Sound medical knowledge, gained through internal training and experience and previous medical background.
• Experience of medical underwriting, risk assessment or claims management and decision-making within the healthcare sector or protection insurance arena.
• Previous experience in the delivery of customer service within a contact centre setting, coupled with experience of case managing customer queries through to resolution
• A track record of achieving and exceeding productivity and quality targets in a high performing team environment
• Highly customer focussed, considering impact on customers and business and responding promptly and co-operatively to internal and external customers balancing decisions with the needs of the customer and of the business.
• Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
• An ability to speak a second language would be an advantage