RN Medical Review Nurse (Hybrid)

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, helping 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.

About the role

Excess Reinsurance is seeking a licensed RN to provide cost projections and underwriter support for the review of medical claims at its Woodbury, NJ location. This full-time position involves reviewing claims data and medical documentation to identify and project future medical risks for underwriting purposes.

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.

Requirements

• 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.
• Strong analytical, organizational, and decision-making skills with a business orientation.
• Excellent written and verbal communication skills.
• Strong digital literacy.

Qualifications

• Must be a Registered Nurse.

Excess Reinsurance Underwriters Agency, Inc. is a market leader in the self-funded insurance market, located in Woodbury, New Jersey, about 12 miles from Philadelphia.

Benefits

• Competitive salary
• PTO & paid holidays
• 401(k) with match
• Best-in-class discount programs
• Health & wellness programs

Pay

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.