Registered Nurse Medical Underwriter
Job Summary
To assess medical risk and predict costs for claims and underwriting, the full-time Registered Nurse Medical Underwriter will analyze clinical data and provide risk assessments while working remotely.
Key Responsibilities
- Assess medical costs and clinical data using various software and data sources
- Provide risk assessment and cost projections based on medical conditions and treatment plans
- Stay updated on medical advancements that impact cost projections and recommendations
Required Qualifications
- Registered Nurse (RN) designation
- 5 years of relevant clinical experience, preferably in acute care or managed care settings
- Strong knowledge of ICD, CPT, medical terminology, COBRA, and HIPAA
- Understanding of third-party administrators (TPAs) and managing general underwriters (MGUs)
- Knowledge of carrier and reinsurer reporting and contractual requirements
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