RN Medical Review Nurse (Hybrid)
NFP Corp•Woodbury, MN
•$77,000 - $94,000•Hybrid
About The Position
Excess Reinsurance is currently seeking a licensed RN to work in its Woodbury, NJ location to provide cost projections and underwriter support for the review of medical claims. This full-time position requires using your extensive knowledge, expertise, and experience to review claims data and medical documentation to identify and project future medical risks for underwriting purposes.
Requirements
- Must be a Registered Nurse
- A minimum of three years clinical RN experience, preferably in a hospital setting.
- At least two years of experience in the health insurance industry with in-depth knowledge of the UR and/or the case management process.
- Must have strong analytical, organizational, and decision-making skills and business orientation.
- Strong digital literacy
- Excellent written and verbal communication skills.
Responsibilities
- Assess claims and medical information to calculate potential risk by identifying claimants with catastrophic care needs.
- Use varying resources to research diagnoses, treatment plans, and average costs.
- Read, analyze, and interpret medical records, claims files, and underwriting reports.
- Provide written assessments within encouraged timeframes for use when establishing rates for new and renewal business.
- Connect with underwriters and Senior Management to advise of potential claims involving significant risk.
- Investigate course of treatment for existing conditions.
- Recommend lasers where warranted.
Benefits
- PTO & paid holidays
- 401(k) with match
- best-in-class discount programs
- health & wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
