Summary
Overview
Work History
Education
Skills
Timeline
Generic

TRACY MCIVOR

Findlay,OH

Summary

A self-motivated and experienced professional with over 20 years combined underwriting experience in multiple market segments in a high volume and fast-paced environment. Specializing in attention to detail, the ability to work on several labor-intensive projects at once and a strong analytical background required to be successful in such a position. Solid communication and critical thinking skills and a successful history of working with multiple departments implementing significant process and system changes.

Overview

28
28
years of professional experience

Work History

Senior Medical Underwriter

Medical Mutual of Ohio
08.2017 - 04.2025
  • Performed comprehensive manual medical underwriting for both group and individual health insurance applicants by analyzing medical and prescription data, medical records, APS reports and utilizing various internal and external resources for evaluation of risk.
  • Integrated AI tools such as Milliman IntelliScript Curv and Gradient AI into the underwriting workflow to enhance risk assessment accuracy and processing efficiency.
  • Researched and escalated potential underwriting concerns or indications of risk manipulation to senior leadership for timely resolution of high-risk cases.
  • Supported Underwriting Compliance Analyst with review of medical records in determining potential fraud/misrepresentation of group/individual policies.
  • Collaborated with Sales to gather missing or updated data required to reassess rating decisions for prospective groups, ensuring accurate and competitive pricing.
  • Researched potential process and system improvements to provide more streamlined data for risk assessment.
  • Communicated key medical risk indicators and high-claimant projections to group underwriters, contributing to balanced renewal pricing strategies.
  • Assisted Underwriting Analysts by making rating recommendations on prospective and renewal business based on profitability and utilization potential to meet corporate goals.
  • Assisted Underwriting Administration Specialists with policy administration tasks such as benefit changes and sold group processing during peak volume periods.
  • Responsible for initiating and implementing a comprehensive spreadsheet tracking all medications dispensed by the company to accurately monitor internal costs and enable appropriate rating decisions.
  • Created a comprehensive process flow document detailing the Medical Mutual underwriting process and delivered it to Milliman for review and collaboration.


Large Group Senior Underwriter

HealthSpan Integrated Care (formerly Kaiser Permanente of Ohio)
10.2010 - 08.2016
  • Calculated renewal rates for Fully Insured Mid-market, Large, National and Key accounts, and all corresponding RFPs, through detailed analysis of statistical data including current marketplace trends, claims experience where applicable, medical history via applications, all relevant demographic information, etc...
  • Worked closely with Finance and Actuary departments to ensure renewal rates and increases aligned with and optimized company membership and revenue goals
  • Prepared and delivered competitive rate quotes and benefit options for prospective business in all large group segments through detailed analysis of competitor data; worked with Sales staff to maximize closing potential
  • In the final 2 years of production, responsible for, and successfully met, all deadlines and requirements for 90% of both the large group Book of Business and prospects/quote requests received.
  • Established strong and effective business relationships with sales and account management staff to optimize opportunities for potential new members and retention of existing members
  • Served as subject matter expert and liaison with vendor for implementation of new rating system (Stepwise). Responsible for all testing involved, weekly calls with consultant and programmer to provide feedback and progress, supplying all pertinent data for customization as well as any modifications needed. Also responsible for training staff and providing detailed documentation regarding instructions and troubleshooting
  • Worked directly with off-site Actuary on various projects including: developing and testing new rating tools; monthly audit of model version data (updated claims and membership) required for the company’s internal rating engine; helping facilitate the integration of these elements into the new rating system (Stepwise)

Associate (Medical) Underwriter/ Underwriter II

Kaiser Permanente of Ohio
10.2005 - 10.2010
  • Responsible for the determination of risk selection and rate adequacy on new business small groups and renewals
  • Produced accurate rate quotes (on average, 300 per month) in compliance with Underwriting and authority guidelines and state and federal laws for existing and/or prospective business
  • Aggressively pursued fraud detection/identification and established policies and procedures to support appropriate and effective legal action
  • Audited quarterly rate hanging process through review of several business applications
  • Assessed existing groups for rate reduction following significant renewal increases
  • Served as back-up coverage for Individual Underwriter and determined preliminary approval/denial for TAA/HCTC applicants
  • Produced multiple reports: Quarterly profit/loss by product line, quarterly Medical Loss Ratio report (required to generate monthly renewals), financial dashboard for Small Group segment, competitive carrier rate and benefit comparisons, weekly quote total comparison versus prior year, various reports upon request

Associate Underwriter

QualChoice
10.2004 - 10.2005
  • Responsible for renewal processing for all small groups (over 1,800 total) on a monthly basis
  • Provided basic quotes for prospective members using census data and demographics
  • Developed and managed new validation project to ensure all existing clients continued to meet Underwriting guidelines as required by state and federal law and Ohio Department of Insurance.
  • Assisted Medical Underwriting staff in assessing risk for prospective small groups

Communications/Data Processor/IT Help Desk/Project Manager

Corporate Collections Services and Call Center Resources, Inc.
11.1997 - 06.2004
  • Oversaw functionality of predictive dialer system for over 100 call center agents on a daily basis including setup, maintenance and error resolution
  • Monitored agents through the use of various dialer applications and tools for maximum quality control
  • Provided detailed reports of agent productivity as it related to individual use of time and correlating program success
  • Utilized various dialer applications for program customization
  • Processed multiple data file types to multiple databases
  • Resolved computer user concerns and issues involving computer software and hardware
  • Managed outsourced prescription discount card program (SaveWell) including staff training, application processing, resolution of complaints, adjudication of rejected claims at various pharmacies via telephone, development of multiple reports detailing program success and areas of improvement, weekly calls with client to provide feedback and address new issues
  • Managed outsourced third party verification program and increased billing by 10%

Pharmacy Technician/Customer Service/Bookkeeper

Discount Drug Mart
01.1997 - 08.2007
  • Processed prescriptions for customers from start to finish for pharmacist approval: Utilized current software program to calculate correct dosages, address any drug interaction issues, prepare prescription label with accurate directions for usage, dispense and fill medications
  • Advised customers on prescription directions, billing inquiries and price discrepancies and worked with insurance companies to adjudicate rejected claims
  • Assisted with prior authorization inquiries and follow-up and obtained refill authorizations for patients from doctors’ offices
  • Reviewed processed prescriptions for accuracy for audit preparation
  • Managed Customer Service/ Courtesy Counter including bookkeeping, balancing cashier tills, accounting register tapes, making daily/nightly deposits, handling customer complaints, providing customer assistance with questions regarding all departments of the store.

Education

Bachelor of Science Degree - Recreation Studies, Therapeutic Recreation

Ohio University
Athens, OH
05.1997

Skills

  • MS Access, Excel, Word, Outlook
  • Stepwise
  • CMS
  • OnBase
  • FormFire
  • MedCompass
  • Impact Pro
  • ClaimsLink
  • SharePoint

Work Type

Full TimeContract Work

Work Location

RemoteHybrid

Timeline

Senior Medical Underwriter

Medical Mutual of Ohio
08.2017 - 04.2025

Large Group Senior Underwriter

HealthSpan Integrated Care (formerly Kaiser Permanente of Ohio)
10.2010 - 08.2016

Associate (Medical) Underwriter/ Underwriter II

Kaiser Permanente of Ohio
10.2005 - 10.2010

Associate Underwriter

QualChoice
10.2004 - 10.2005

Communications/Data Processor/IT Help Desk/Project Manager

Corporate Collections Services and Call Center Resources, Inc.
11.1997 - 06.2004

Pharmacy Technician/Customer Service/Bookkeeper

Discount Drug Mart
01.1997 - 08.2007

Bachelor of Science Degree - Recreation Studies, Therapeutic Recreation

Ohio University

Similar Profiles

CREATE PROFILE