As a QC Associate in Tele-Medical Underwriting, you'll ensure the accuracy, compliance, and quality of tele-underwriting assessments--conducted via phone or video--as part of the medical underwriting process. You'll audit case documentation, assess adherence to underwriting standards, provide feedback, and help drive improvements in the underwriting quality and workflow.
Key Responsibilities
Quality Audits & Compliance Checks
Conduct systematic reviews of tele-underwriting assessments and documentation against company and regulatory standards--similar to roles in medical pre-underwriting quality review where accuracy and compliance are emphasized.
Ensure teleMER (Medical Examination Report) calls are completed timely and correctly, as seen in tele-underwriter responsibilities.
Error Trend Analysis & Reporting
Identify recurring errors or process gaps and recommend corrective actions; this parallels error-trend reporting duties in quality review roles.
Maintain audit logs and prepare quality reports for management, providing actionable insights.
Feedback & Training Collaboration
Offer feedback to underwriting and tele-underwriting teams to improve accuracy and consistency.
Assist training teams to address knowledge gaps and support continuous improvement initiatives.
Process Improvement & SOP Updates
Participate in updating standard operating procedures (SOPs) based on audit findings and collaborate in process enhancements.
Support system testing and enhancements related to underwriting rules and tele-underwriting tools.
Escalation & Complex Case Review
Review escalated or complex tele-underwriting cases for completeness and accuracy; offer guidance and resolution pathways.
Data Security & Confidentiality
Ensure the integrity and confidentiality of sensitive medical data and patient records are maintained throughout audits and reviews.
Required Qualifications
Education
Bachelor's degree in Life Sciences, Healthcare, Insurance, or a related field (e.g., Nursing, Healthcare Administration)
BHMS and BAMS preferable.
Experience
1-3 years in medical underwriting, tele-underwriting, quality control, or a related domain.
Skills & Knowledge
Strong analytical and detail-oriented mindset to identify underwriting inaccuracies and risk factors.
Familiarity with medical underwriting guidelines, teleMER processes, and regulatory frameworks.
Experience using relevant tools or systems for underwriting quality review.
Excellent written and verbal communication skills for clear feedback delivery.
Ability to adapt, collaborate, and contribute to process improvements.
Preferred Qualifications (Optional)
Certifications in underwriting, risk management, or quality control.
Experience with tele-underwriting platforms or electronic audit systems.
Multilingual skills, depending on locale or customer base.
Health insurance
Provident Fund
Application Question(s):
Can you explain the tele-underwriting (teleMER) process and your role in ensuring its quality and compliance?
What steps would you take if you found a critical error in a high-value underwriting case?
Have you done the Bachelor's in any of the below mentioned degree?
Bachelor's degree in Life Sciences, Healthcare, Insurance, or a related field (e.g., Nursing, Healthcare Administration)
BHMS and BAMS preferable
Do you have an experience in Medical underwriting, tele-underwriting, quality control, or a related domain?
Work Location: In person
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