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Medical Insurance Underwriter Career

How to Become a Medical Insurance Underwriter

Health insurance underwriters have a unique career path that typically starts with a bachelor's degree. However, unlike many other professions, they obtain most of their technical knowledge through on-the-job training and working closely with a senior underwriter.  

This career can be challenging because your analysis and decisions affect the profitability of your employer's business. At the same time, skilled underwriters are in higher demand because medical insurance is necessary for almost everyone, so more people apply for it than seek other forms of coverage. 

Here is a closer look at what it takes to begin a career in this challenging and unique field.

What Is a Medical Insurance Underwriter?

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 is 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 insurance 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 the same regardless of where the medical insurance underwriter works. 

What Education Does a Medical Insurance Underwriter Need?

Applicants for entry-level medical insurance underwriter positions 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 health leadership 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.

Health Information Management – B.S.

A program designed for future leaders in HIM:...

A program designed for future leaders in HIM:...

A program designed for future leaders in HIM:

  • Time: 60% of grads earned this degree in 36 months or less.
  • Tuition and fees: $3,795 per 6-month term, plus a Health Professions Student Fee of $350.

Some careers and jobs this degree will prepare you for:

  • Director of informatics
  • HIMS chief
  • Information systems auditor
  • Outpatient coder
  • Health records manager

This CAHIIM-accredited program makes you eligible for the RHIA exam. 

Compare with B.S. Business – Healthcare Management

Master of Health Leadership

A master's focused on managing comprehensive, value-based care,...

A master's focused on managing comprehensive,...

A master's focused on managing comprehensive, value-based care, directly in line with innovations in health and healthcare.

  • Time: 78% of grads finish within 24 months. 
  • Tuition and fees: $4,385 per 6-month term.

Examples of careers and jobs this degree will prepare you for:

  • Managed care executive
  • Director of integrated care management
  • Health center manager/clinic manager
  • Director of integrated facilities

Your rich experience in a health-related field can mean more when you bring a master's level of understanding to the problems that organizations need to solve.

Compare degrees
This program is not the only degree WGU offers designed to create leaders in the field of healthcare. Compare our health leadership degrees by clicking the button below.

Compare Similar Degrees

MBA Healthcare Management

Prepare for a career leading private or public healthcare...

Prepare for a career leading private or public...

Prepare for a career leading private or public healthcare organizations.

  • Time: Graduates can finish within 12 months.
  • Tuition and fees: $4,675 per 6-month term.

Some careers and jobs this business degree will prepare you for:

  • President and CEO
  • Vice president
  • Administrative director
  • Chief financial officer
  • Other executive-level roles

Healthcare is big business in today's complex economy.  Steer your career with this specialty MBA.

Compare online business degrees

This program is not the only online business degree WGU offers that is designed to create leaders in the field of healthcare. Compare our health leadership degrees by clicking the button below.

Compare Similar Degrees

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Medical staff sit around a conference table discussing business things.

What Skills Does a Medical Insurance Underwriter Need?

To succeed as a medical insurance underwriter, you need both technical (hard) and soft skills. You can start gaining these during your undergraduate studies and develop them through on-the-job training. 

  • Medical data analysis: A medical insurance underwriter should be proficient with medical terminology and the classification systems used by healthcare professionals. They should be able to read and understand medical reports and records. 
  • Math and statistics: A medical insurance underwriter should also have math and statistical skills to perform risk assessments and calculate premiums based on variables collected during the assessment process.
  • Computer skills: Direct insurance providers and brokerages typically use underwriting software to help with risk assessments and premium calculations. Though entry-level underwriters receive training in their employer’s chosen software, they need basic computer and math skills to master this aspect of the job.  
  • Soft skills: Soft skills are an essential part of this career. You can develop them during your undergraduate studies or in an entry-level job. Some of the necessary soft skills for a medical insurance underwriter’s career include: 
  • Attention to detail: As they evaluate patient information and assess risks, medical insurance underwriters need to be very accurate. This applies to collecting and analyzing information and making risk assessments and premium calculations. 
  • Analytical skills: Though insurance providers typically have a system for assessing each application, no two applicants will be the same. Because of the differences, underwriters have to constantly analyze information and come up with a unique assessment of each case. 

Mastering these skills plays a significant part in determining your salary and career advancement. 

How Much Does a Medical Insurance Underwriter Make?

$71,790

According to the U.S. Bureau of Labor Statistics, the average yearly salary for insurance underwriters was $71,790 in May 2020. The top 10% earned more than $129,550, while the lowest average was $43,210. Your exact salary will vary depending on education, years of experience, and location. Having certifications, advanced degrees, or experience or education in healthcare can also affect your earning potential.

What Is the Projected Job Outlook?

6% Decline

The demand for insurance underwriters is projected to decrease by 6% from 2019 to 2029. The steady decline is a result of the adoption of automated underwriting software. These AI tools handle the research, risk assessment, and premium calculations. 

However, underwriters may find related positions. For example, companies may still need them to review and update the criteria for automated assessment. In addition, they can still lend insights to complicated applications, evaluate group insurance policies, and make changes to the software programs to account for new regulations or rules in the health insurance industry.

Where Do Medical Insurance Underwriters Work?

Varies

Medical insurance underwriters find employment with different types of insurance providers. You will almost always work in an office setting, although there are some opportunities to work remotely. 

Here are the different places where you can find employment:

-Direct insurance providers: You can work for a company that provides insurance directly to customers. 

-Insurance agencies and brokerages: Qualified underwriters also work for third-party companies that sell policies for a health insurance provider.

-Government agencies or non-profits: Some insurance underwriters can work for government agencies or non-profit groups that provide healthcare coverage for low-income clients.

Regardless of where you work, the educational requirements are the same.

Interested in Becoming a Medical Insurance Underwriter?

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