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Expect scenario questions on pricing a stop-loss case with incomplete claims data, explaining decline or load decisions, and partnering with sales under time pressure. Prepare concise examples of risk assessment, stakeholder communication, and how you stay current on medical cost trends relevant to Highmark’s insurance business.
Strong fit if you already underwrite medical stop-loss or complex group health risk and want senior case authority inside a large integrated insurer. Less ideal if you need remote work or entry-level underwriting training.
As a Senior Medical Stop Loss Underwriter at Highmark Health, a typical day centers on reviewing large-group stop-loss submissions, assessing medical risk and claims history, pricing or quoting excess coverage, and documenting underwriting rationale. You would coordinate with sales, brokers, and clinical or actuarial partners, escalate complex cases, and keep files aligned with Highmark’s medical-stop-loss guidelines and turnaround standards.
Build depth in medical stop-loss pricing, group health and claims analytics, and regulatory/compliance basics for health insurance risk. Strengthen judgment on large-case review and clear written recommendations. No certification list or costs were supplied for this posting.
No. The listing is Oklahoma City–based with remote set to off.
It is a nonprofit healthcare company and integrated delivery network that includes major health insurance operations, described on Wikipedia and highmarkhealth.com.
Prior medical stop-loss or group medical underwriting experience, comfort with claims-driven risk analysis, and clear documentation of pricing decisions.
Website: highmarkhealth.com
Highmark Inc is an American nonprofit healthcare company and integrated delivery network based in Pittsburgh. It is a large individual health insurer in the United States, which operates several nonprofit and for-profit subsidiaries.
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Senior Medical Stop Loss Underwriter, Highmark Health — Oklahoma City, Oklahoma County Role Overview This role involves pricing quotes and analyzing the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of Underwriting authority within the policies of HMIG and ensures appropriate levels of profitability and growth over time. Responsibilities Priced quotes and analyzed contracts for groups based on claims experience and group characteristics Used discretion in Underwriting authority to ensure profitability and growth Identified when to decline quotes that do not meet the criteria for underwriting approval Skills & Qualifications Strong understanding of medical stop loss insurance principles and practices Experience in analyzing claims data and risk assessment Able to make sound judgment calls based on complex information Proficient in using underwriting software and tools Excellent communication and interpersonal skills for client interaction Strong analytical and problem-solving abilities More About Highmark Health Highmark Health, through HM Insurance Group, provides comprehensive insurance solutions to various groups. The company is committed to delivering high-quality services while ensuring the financial stability of its clients. Applying for This Role To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.
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