What are the responsibilities and job description for the Medical Underwriter RN position at J & J Staffing Resources?
J & J Staffing Resources seeks an accomplished RN to work on-site at our Woodbury location. As a Clinical Claims Specialist, you will analyze medical data to determine potential risk for underwriting purposes.
Your duties will include:
- Analyzing medical records, claims files, and underwriting reports to identify potential risks
- Researching diagnoses, treatment plans, and average costs to inform underwriting decisions
- Communicating with underwriters and Senior Management to advise on potential claims involving significant risk
- Investigating courses of treatment for existing conditions
To be successful in this role, you will need:
- Registration as a Registered Nurse (RN)
- 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 case management process
- Strong analytical, organizational, and decision-making skills, as well as business orientation
- Strong computer skills
- Excellent written and verbal communication skills
