St. Coletta is an organization that offers residential and vocational rehabilitation, serving individuals with developmental disabilities and mental illness in the Southern Wisconsin and Illinois area.

Responsible for the assessment of medical and non-medical risk presented through a systematic and thorough review in order to determine an applicant’s eligibility for individual major medical coverage. *Risk Assessment of Individual Medical & high risk applicants*Review medical questions and other application information for accuracy and completeness in order to determine underwriting eligibility requirements or action*Review and understand the implications and requirements of data following state mandates*Understand health conditions to properly utilize and appropriately apply underwriting guidelines*Utilization of various medical resources required to appropriately comprehend medical conditions and potential risks*Recognize when additional information should be pursued through telephone interviews, paramed exams and medical records requests*Conduct telephone interviews in a professional and HIPAA compliant manner for the purpose of clarifying health history*Interpretation and documentation of lab and exam results, attending physician statements, information garnered from outside sources, prior underwriting actions, prior claims experience/actions*Compliance with HIPAA/Guaranteed Issue workflows*Understanding products/benefits *Review and respond to verbal and written appeals on underwriting decisions*Respond to e-mail inquiries and voicemails in a reasonable time frame*Resource for internal and external customers and the management staff.*Ability to clearly and concisely explain process, decisions and the reasons behind each*Meet/exceed departmental standards for underwriting quality*Meet/exceed departmental standards for compliance issues*Provide input to and support implementation of workflow changes and system development*Participate in required projects

Answer inquiries as well as provides sales information and education to State Farm Agents to contribute to the attainment of Assurant Health revenue and profitability targets. *Provide explanation and education on health insurance product offerings, marketing materials and company processes. *Assist Agents through the State Farm ABS system along with the Assurant Health EASE system as well as provide them with updates and status information. Inform them of missing information and provide tools and assistance with satisfying open requirements. Build relationships with agents by providing sales tips as well as anticipating next steps. *Fulfill Agent requests for assistance through the application and underwriting process. Provide Presale Underwriting and Sales Support to agents. *Utilize multiple computer systems to access product information, insureds database, medical information, and other relevant information to respond to inquiries.*Document updates and communications with agents and insureds in the appropriate system. *Complete proper follow through with agents on problem files or escalated situations and provide call backs to agents with findings and results when appropriate.