What are the responsibilities and job description for the Healthcare Risk Consultant position at J & J Staffing Resources?
Our client, a leading healthcare provider, is seeking an experienced RN to join its team as a Healthcare Risk Consultant. In this full-time position, you will work closely with underwriters and senior management to identify and project future medical risk for underwriting purposes.
The ideal candidate will have extensive knowledge of medical claims data and documentation, with strong analytical and organizational skills. This role requires the ability to assess claims and medical information, research diagnoses and treatment plans, and interpret medical records and underwriting reports.
Responsibilities include:
- Assessing claims and medical information to calculate potential risk
- Using varying resources to research diagnoses and treatment plans
- Reading, analyzing, and interpreting medical records and underwriting reports
- Providing written assessments within expected timeframes
- Communicating with underwriters and senior management
Requirements:
- Registered Nurse
- Three or more years clinical RN experience, preferably in a hospital setting
- Two or more years of experience in the health insurance industry
- Strong analytical, organizational, and decision-making skills
- Excellent written and verbal communication skills
