Lead Specialist - Medical Underwriting

Transform insights into action and impact.

About the Role

To provide highlevel technical underwriting expertise by managing complex and highrisk medical assessments, appeals, and escalations, while supporting underwriting and issuance operations across engagement channels (including Virtual Appointments, Live Chat, and Callback) and leveraging digital and AIenabled tools to enhance productivity, quality, and customer experience within agreed Service Level Agreements (SLAs) and a multiskilled operating model.

Underwriting & Service Operations (70%)

• Process and underwrite assigned cases in accordance with approved underwriting guidelines and SOPs, based on direction from the immediate supervisor or manager.
• Exercise independent underwriting judgement within delegated authority limits for complex and highrisk medical cases (+150% extra mortality and above), including handling appeals and complaintrelated underwriting assessments.
• Act as countersignatory and quality gatekeeper for complex cases, ensuring sound judgement, consistency, and auditdefensible decisions.
• Review cases completed by Specialists and below provides technical feedback, and act as escalation point for complex medical assessments.
• Provide expert technical guidance and coaching to Specialists and below on underwriting interpretation, risk assessment, and decision rationale.
• Support underwriting guideline refinement, risk standardization initiatives, and contribute to the development and validation of AIenabled underwriting logic and decisionsupport tools.

Business Support (30%)

• Perform reasonable adhoc duties aligned with underwriting operations, service delivery, quality improvement, or business continuity needs, including performing other responsibilities and duties periodically assigned by the immediate supervisor or manager to meet business requirements.