Group UnderwriterAppleOne

AppleOne, a division of the Act-1 Group, is proud to present:

We are seeking a detail-oriented Group Underwriter for a direct opportunity in San Juan, PR within the health insurance industry. This role is ideal for a candidate with strong analytical skills, health insurance knowledge, and experience working with claims, utilization, benefits, demographic, and financial data.

In this position, you will support the renewal process for fully insured group health and life insurance accounts by preparing claims projections, reviewing utilization trends, and developing data-driven analyses that help guide rate recommendations and business decisions. The role offers the opportunity to work in a collaborative, professional environment with supportive leadership, cross-functional teamwork, and exposure to healthcare insurance operations, pricing, renewals, and client support processes.

Key Responsibilities

- Collect, validate, and analyze claims, utilization, benefits, demographic, and financial data for fully insured group account renewals.
- Extract, maintain, and organize data from internal systems to support pricing analysis, claims projections, and renewal evaluations.
- Apply established methodologies and actuarial factors to assist with renewal rate analyses and claims cost projections.
- Evaluate plan design changes, including copayments, deductibles, and coinsurance, and assess their impact on utilization and claims costs.
- Review claims experience, utilization patterns, and renewal history to identify trends, variations, and account performance factors.
- Collaborate with Account Executives and internal departments by providing renewal-related analysis and responding to information requests.