Underwriter I

Job Title: Underwriter IFLSA Status: Exempt

Department: Underwriting

Reports To: Manager, Underwriting

Position Summary: The Underwriter I underwrites group dental and vision business of routine to limited complexity for new sales, renewals, and plan changes, including independently completing non-experience-rated pricing and independently underwriting standard experience-rated cases within established guidelines. This role analyzes group data, experience, and plan documentation to develop accurate pricing and benefit recommendations aligned with compliance requirements, internal underwriting guidelines, and profitability objectives. The Underwriter I contributes to organizational financial performance by ensuring rate accuracy, data integrity, and operational execution through the Group Onboarding and Administration Tool (Cortex). The Underwriter I also supports the organization’s compliance posture by validating that submitted RFPs, plan changes, and implementation requests contain complete and accurate information prior to downstream processing (e.g., contract issuance, plan setup, and administration).Underwriting workflow execution in Cortex is a shared team responsibility. The Underwriter I independently completes assigned workflow tasks for an assigned block/portfolio and provides shared queue coverage during peak periods, escalating non-standard issues as appropriate. Essential Functions and Job Responsibilities1. Rate Development and Benefit Plan Review (Routine to Limited Complexity) This work may include but is not limited to: Analyze group census, experience (as applicable), utilization summaries, and other inputs to develop rates for dental and vision products for new business, renewals, and plan changes for routine/limited complexity cases (non-experience-rated and standard experience-rated); Apply established guidelines/parameters to complete pricing and benefit recommendations for routine/limited complexity cases; escalate non-standard requests, higher-risk items, or deviations as appropriate; Review Summary Plan Descriptions (SPDs), benefit certificates, and related plan documents to identify benefit plan design provisions, differences, and administrative considerations that impact pricing and benefit administration; Apply established underwriting guidelines, tools, and methodologies to support pricing and benefit determinations aligned with organizational objectives and market competitiveness; Prepare quotes, renewals, and supporting documentation in a timely and accurate manner and ensure underwriting files include clear rationale and supporting data; Partner with Account Management to align deliverables with client requirements and internal standards.2. Pricing Support and Actual-to-Expected ReviewThis work may include but is not limited to: Support actual-to-expected analysis by validating claims projections and assisting in identifying variances, data anomalies, or trend indicators; Document findings and elevate notable deviations for review to support continuous improvement in pricing accuracy and profitability; Run GEO access and disruption reports (as assigned) to support network access evaluation and client/broker discussion; interpret findings, document implications, and communicate insights to Sales and Account Management.3. Group Onboarding & Implementation Workflow Execution, Exception Identification, and Shared Queue Coverage This work may include but is not limited to: Independently complete assigned underwriting workflow steps in Cortex for new group implementations and ongoing group maintenance for an assigned block/portfolio to ensure timely and accurate progression of deliverables; Provide shared queue workload support (including during peak volume periods) to maintain service levels and implementation timelines; Serve as a control point (“gatekeeper”) by validating that submissions (RFPs, renewals, and group changes) are complete, accurately documented, and aligned with regulatory requirements and internal underwriting guidelines after progressing in Cortex; identify missing items or discrepancies and coordinate corrections and/or escalate for resolution as appropriate; Ensure data integrity within Cortex to reduce downstream impacts (e.g., contract/benefit documentation inconsistencies, plan setup issues, billing/reporting discrepancies, claims configuration errors); Identify workflow exceptions, bottlenecks, or cross-functional handoff issues; resolve routine discrepancies within established procedures and escalate non-standard, higher-risk, or complex system/process issues as appropriate; Participate in testing support and provide feedback for Cortex enhancements and related systems/process changes, as assigned.4. Contract and Benefit Document SupportThis work may include but is not limited to: Support preparation of standard ASC contract components and documentation for new and existing clients based on approved group specifications; Assist with review and customization of benefit booklets to reflect approved plan designs and ensure alignment between underwriting intent and documentation.5. Stakeholder Collaboration and Service This work may include but is not limited to: Communicate underwriting decisions and key plan/rate information to Account Management, Sales and other internal partners within defined scope; Respond to internal questions and routine broker/client inquiries, escalating complex or sensitive issues as appropriate; Maintain professional and timely communication to support service expectations.6. Training, Development, and Team SupportThis work may include but is not limited to: Participate in training to build proficiency in underwriting methods, benefit plan interpretation, Cortex workflows, and documentation standards; Contribute to team discussions and assist with coverage during high-volume periods to maintain continuity of work; Support process improvement and system enhancement efforts by participating in assigned project tasks and testing activities (e.g., executing test cases, documenting results/defects, and providing feedback), under guidance; Maintain confidentiality and protect company and client data in compliance with policy and regulatory requirements. Regular and reliable attendance is required. Other duties and responsibilities may be assigned.

Qualifications: Bachelor’s degree in Mathematics, Statistics, Finance, Business, Actuarial Science, or a related field, required; equivalent professional experience may be considered.0–2 years of underwriting, pricing, benefits, or group insurance-related experience preferred (or equivalent proficiency).Proficiency in Microsoft Excel and Word; familiarity with Access and workflow management systems preferred. Ability to interpret benefit plan documents (SPDs/certificates) with developing knowledge of dental and vision plan design features. Strong analytical skills, attention to detail, and ability to manage multiple tasks with competing deadlines. Effective written and verbal communication skills and ability to work collaboratively across teams. Demonstrated commitment to the company’s core values of integrity, adaptability, service-focused, accountability, curiosity, and community.

Physical and Other Demands: Specific vision abilities required by this job include the ability to adjust focus. While performing the duties of this job, the employee is regularly required to sit, talk and hear. The employee is frequently required to use hands and arms to handle, feel, reach and operate a computer. This job requires substantial typing. The ability to manage multiple tasks and shift focus between tasks, screens, and systems is essential. The position requires the ability to work in a fast-paced environment and manage stress effectively. DDMO provides reasonable accommodation to qualified individuals with a known disability unless doing so imposes an undue hardship. Employees must be able to successfully perform the essential functions of this role with or without a reasonable accommodation.

Disclaimer: This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties or responsibilities that will be required. The organization reserves the right to modify this job description at any time; including assigning or reassigning job duties.