RN Medical Review Nurse (Hybrid)
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At a glance
Requirements
Credentials this posting asks for.
Job overview
AON is hiring a RN Medical Review Nurse (Hybrid). The role involves a licensed RN reviewing medical claims and providing cost projections for underwriting, requiring strong analytical abilities, digital literacy, and communication skills while collaborating with underwriters and senior management in Woodbury, NJ.
Key focus areas include Assess claims and medical information to calculate potential risk, Research diagnoses, treatment plans, and average costs, and Read, analyze, and interpret medical records, claims files, and underwriting reports.
Important skills include Analytical Skills, Organizational Skills, Decision-Making Skills, Digital Literacy, and Communication.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Posting Description
Who We Are:
NFP, an Aon Company, is a multi-year Best Places to Work award winner in Business Insurance. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the world address their most significant risk, workforce, wealth management, and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com.
Summary of Role:
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.
Essential Duties and 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.
Knowledge, Skills, and/or Abilities:
-
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.
Certificates, Licenses, Registration:
- Must be a Registered Nurse
Excess Reinsurance Underwriters Agency, Inc. is a market leader in the self-funded insurance market. Excess Reinsurance is located in Woodbury, New Jersey, about 12 miles from Philadelphia. Please submit your resume and cover letter with salary requirements.
What We Offer:
We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, best-in-class discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, when all is said and done, we exist to be there for others. The base salary range for this position is $77,000 – $94,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.
NFP and You... Better Together!
NFP is an inclusive Equal Employment Opportunity employer.
2585475 Who We Are:
NFP, an Aon Company, is a multi-year Best Places to Work award winner in Business Insurance. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the world address their most significant risk, workforce, wealth management, and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com.
Summary of Role:
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.
Essential Duties and 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.
Knowledge, Skills, and/or Abilities:
-
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.
Certificates, Licenses, Registration:
- Must be a Registered Nurse
Excess Reinsurance Underwriters Agency, Inc. is a market leader in the self-funded insurance market. Excess Reinsurance is located in Woodbury, New Jersey, about 12 miles from Philadelphia. Please submit your resume and cover letter with salary requirements.
What We Offer:
We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, best-in-class discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, when all is said and done, we exist to be there for others. The base salary range for this position is $77,000 – $94,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.
NFP and You... Better Together!
NFP is an inclusive Equal Employment Opportunity employer.
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