Review lengthy or complex medical records (APS, lab reports, physician notes, hospital discharge summaries) and identify clinically significant findings relevant to underwriting risk.
Produce concise, standardized summaries highlighting diagnoses, chronic conditions, treatment timelines, medications, surgical history, and red-flag findings (e.g., cardiac, oncology, mental health, substance use).
Flag missing, unclear, or contradictory medical information that may require follow-up with the applicant, physician, or requester.
Apply consistent formatting/templates so underwriters can quickly locate key data points without reading full files.
Maintain strict confidentiality and compliance with HIPAA/data privacy and regional health-data regulations.
Collaborate with managers, leaders to clarify ambiguous cases.
Identify patterns or risk factors (e.g., recurring conditions, family history, lifestyle risks) that may affect premium calculation or policy terms.
Meet turnaround time (TAT) targets and quality benchmarks for each case reviewed.
