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ACKO is seeking an experienced Core Medical Underwriter (CMU) to serve as the final medical decision authority for health insurance cases requiring clinical evaluation. This role combines strong clinical risk assessment with exceptional customer engagement, requiring the ability to interpret specialized cardiac tests and directly communicate underwriting outcomes with empathy and clarity.
Key Responsibilities:
• Evaluate health insurance applications, customer medical history, and clinical documentation to perform comprehensive medical risk assessments
• Review cases post-PPMC (Pre-Policy Medical Check) and determine underwriting outcomes including standard acceptance, loading, exclusions, postponement, or decline
• Demonstrate specialized capability in interpreting advanced cardiac investigations, including ECG, 2D Echo, and TMT (Treadmill Test)
• Conduct high-quality Tele-Medical Evaluations (Tele-MER) and clearly explain complex reproposals, loadings, or requirements to customers
• Maintain high standards of documentation accuracy, ensure strict compliance with internal and regulatory guidelines, and deliver decisions within SLAs
The role requires balancing rigorous clinical judgment with strong interpersonal skills, operating in a fast-paced, digital-native environment.
Required Qualifications & Competencies:
• MBBS or BDS degree from a recognized medical institution with valid Medical Council registration
• Minimum 3 years of experience in health insurance underwriting, clinical risk assessment, or medical adjudication
• Proven mastery in evaluating laboratory reports and specialized diagnostic profiles, specifically ECG, 2D Echo, and TMT
• Excellent verbal communication, customer-centric call handling qualities, and active listening skills
• High attention to detail, strong problem-solving skills, and comfort operating in a fast-paced, digital-native environment
