Medical Review Nurse Id-3938
Full Job Description
Who We Are
NFP, an Aon Company, is a multi-year Best Places to Work award winner in Business Insurance who has also earned the 5-Star Diversity, Equity and Inclusion (DEI) award from Insurance Business magazine and the WORK180 employer endorsement. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe 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 expected timeframes for use when establishing rates for new and renewal business.
- Communicate 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:
- Three or more years of clinical RN experience, preferably in a hospital setting.
- Two or more years of experience in the health insurance industry with in-depth knowledge of the UR and/or the case management process.
- Experience with Cost Evaluations and Projections required.
- Must have strong analytical, organizational, and decision-making skills and business orientation.
- Strong computer skills
- Excellent written and verbal communication skills.
- Must be able to work EST hours Monday through Friday.
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
NFP is proud to offer a competitive salary, PTO and paid holidays, 401(k) with match, exclusive discount programs, health and wellness programs, and more. Our people-first culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others.
NFP and You... Better together!
