Medical Underwriter

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: - ( - )

Experience: 3+ yrs

Location: Gurgaon, Delhi, India

As a Medical Underwriter, you will be responsible for reviewing medical records, evaluating applicants' health profiles, and assessing medical risks to support accurate and consistent underwriting decisions. You will analyze medical histories, laboratory reports, diagnostic findings, treatment records, and other relevant clinical documentation to determine risk eligibility and appropriate underwriting outcomes.

You will collaborate with underwriting teams, medical professionals, claims teams, and other stakeholders to clarify medical information, resolve discrepancies, and ensure decisions are based on sound medical judgment and established underwriting standards. The role requires strong analytical skills, attention to detail, confidentiality, and the ability to interpret complex medical information effectively.

Requirements

Key Responsibilities

• Review and interpret medical records, clinical histories, diagnostic reports, laboratory results, and other health-related documentation.
• Evaluate medical and health information to assess risk eligibility and determine appropriate underwriting decisions.
• Apply medical knowledge to understand existing conditions, pre-existing diseases, treatment histories, complications, and associated risk factors.
• Assess medical disclosures and identify inconsistencies, missing information, or potential risk indicators.
• Evaluate applications in accordance with established medical underwriting guidelines, risk assessment frameworks, and organizational policies.
• Determine the need for additional medical information, investigations, or clarification to support accurate risk evaluation.
• Collaborate with medical consultants, underwriting teams, and other stakeholders to resolve complex cases and support appropriate decisions.
• Maintain accurate documentation of medical assessments, risk classifications, and underwriting decisions.
• Ensure compliance with applicable regulatory requirements, data privacy standards, confidentiality policies, and internal procedures.
• Monitor underwriting quality and turnaround times while maintaining accuracy and consistency in decision-making.
• Stay updated on medical developments, disease classifications, underwriting practices, and relevant industry standards.
• Support continuous improvement initiatives to enhance underwriting efficiency, risk assessment accuracy, and overall process quality.

What Makes You a Great Fit?

• Bachelor's degree in Medicine, Nursing, Pharmacy, Life Sciences, or a related healthcare discipline. A medical degree or relevant clinical qualification is an advantage.
• Minimum of 3 years of relevant experience in medical underwriting, preferably in the insurance or healthcare industry.
• Strong medical knowledge, including an understanding of common diseases, chronic conditions, pre-existing medical conditions, treatments, and associated complications.
• Proven ability to interpret medical records, clinical histories, laboratory reports, diagnostic findings, and other medical documentation.
• Good understanding of medical underwriting principles, risk assessment methodologies, eligibility criteria, and underwriting guidelines.
• Ability to identify medical risk factors, evaluate complex health information, and make evidence-based underwriting recommendations.
• Strong analytical thinking, attention to detail, and decision-making skills.
• Excellent written and verbal communication skills, with the ability to explain medical findings and underwriting decisions clearly.
• Ability to handle confidential medical information responsibly and maintain strict data privacy standards.
• Strong organizational skills and the ability to manage multiple cases while meeting turnaround time and quality expectations.
• Proficiency in MS Office and familiarity with insurance underwriting systems or medical case management platforms is an advantage.
• A high level of integrity, professional judgment, and commitment to accuracy, consistency, and quality in medical underwriting.