Medical Underwriting Nurse

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate medical risk and forecast medical costs associated with care for claims and underwriting purposes.

• Analyze medical costs and clinical data using various data sources and software tools.

• Deliver risk evaluations and cost estimates for underwriting and claims based on medical conditions, treatment strategies, and medication expenses.

• Keep informed about the latest medical innovations and their implications on cost assessments and recommendations.

⛳️ Requirements

• Must possess a Registered Nurse (RN) designation.

• A minimum of 5 years of relevant clinical experience, ideally in acute care or managed care settings.

• In-depth medical knowledge, including familiarity with International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA.

• Strong understanding of the operations of third-party administrators (TPAs) and managing general underwriters (MGUs).

• Awareness of Carrier and Reinsurer reporting and contractual obligations.

• Ability to apply extensive knowledge of principles, practices, and procedures in the field.

• Excellent written and verbal communication skills, emphasizing confidentiality, tact, and diplomacy.

• Outstanding organizational and analytical abilities; proven capacity to handle multiple tasks concurrently.

• Well-informed about industry changes, legal updates, and technical advancements relevant to the Company’s business to proactively address evolving business conditions.

🏝️ Benefits

• Competitive salary along with a comprehensive benefits package.

• Strong culture of learning with continuous development opportunities.

• Opportunities for professional growth and career advancement.

• Comprehensive medical, vision, and dental coverage, starting on your first day of employment.

• Basic life and disability insurance.

• 401(k) plan with a 6% company match.

• 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off.

• Paid parental leave.

• Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription.

• Student loan matching program.

• Employee discount program.

• An opportunity to engage in meaningful work and enjoy what you do.