Underwriting Assistant

Description

Job Summary: This role aims to ensure claims control by applying underwriting policies and business rules, managing medical reviews, recording diagnoses, communicating with members, and establishing B2B companies. Key Responsibilities: 1. Ensure claims control through underwriting policies. 2. Manage case reviews for declared or undeclared pre-existing conditions. 3. Respond to inquiries from internal and external customers. **Job Description** ---------------------- Ensure claims control through the application of underwriting policies and business rules. 1\. Review 100% of Health Declaration Forms (HDFs) submitted by members who provided an affirmative response during enrollment. 2\. Coordinate with the Medical Audit team to review cases involving declared or undeclared pre-existing conditions, as applicable. 3\. Record in the system the medical diagnoses declared in the HDF or undeclared pre-existing conditions identified during each member’s coverage period. 4\. Send subscription-related communications to members regarding their HDF enrollment. 5\. Coordinate with the Member Experience team to process membership cancellations due to non-compliance with subscription deadlines. 6\. Generate follow-up reports showing performance indicators for each process handled. 7\. Update subscription letters according to updates in program terms and conditions. 8\. Manage the creation of new B2B companies and ensure correct completion of the onboarding process. 9\. Adapt contracts and addenda according to the commercial characteristics of new B2B companies. 10\. Coordinate with internal departments to review clauses included in each contract template. 11\. Ensure compliance with requirements for B2B company openings and renewals. 12\. Manage the signing of contractual documents for B2B companies. 13\. Respond to inquiries from internal and external customers. 14\. Evaluate exceptional cases related to business rules in coordination with the Product team. 15\. Report monthly risk events. **Candidate Requirements** -------------------------- * Completed degree in Business Administration, Industrial Engineering, or related fields. * Minimum 1 year of experience in operations areas within companies. * Preferred experience in banking, insurance, telecommunications, retail, or related sectors. This position is open to persons with disabilities. **Selection Process** ------------------------ The selection process is conducted via Aira — a recruitment platform designed to enhance your application experience. To apply, you only need: 1\. Apply to this job posting. 2\. Check your email. 3\. Access Aira and answer the requested questions and/or assessments. If your profile matches our requirements, we will contact you by email (via Aira) to proceed to the in-person stage. **About Us** ------------------ Auna is a leading organization whose primary commitment is to deliver health and wellbeing to its members and patients. We continuously pursue innovation to provide high-quality, accessible health solutions for everyone. We operate in Peru, Colombia, and Mexico, and employ over 14,500 collaborators. At Auna, we implement an integrated, person-centered healthcare model — the most important pillar of our mission. **Our Benefits** ----------------------- Formal employment registration with all statutory benefits. A mixed Health Plan for you and your eligible dependents, covering 85% (under the Base Mapfre Plan) and 75% (under the additional Corporate Auna Salud Plan). A 100% covered Oncology Program for the primary member and eligible dependents. Corporate benefits and a discount club. Half-day off on your birthday. Study scholarship program: “Challenge Yourself with Auna”. Recognition program. Food card. At AUNA, we are committed to Diversity, Equity, and Inclusion; therefore, all candidates are considered equally throughout our selection processes, without distinction based on sexual orientation, disability, gender, age, ethnicity, race, or other factors.