ZipRecruiter

Log In

1

Intern Stop Loss Rn Jobs (NOW HIRING)

Ballad Health

Nurse Intern

Sneedville, TN · On-site

$12.50 - $16.25/hr

Nurse Intern (Varied Shifts) Emergency Dept - Sneedville, TN - 24534 Hancock County Hospital ... Able to care for patients with varying levels of illness under the direction of an RN. Routine ...

Ballad Health

Nurse Intern

Kingsport, TN · On-site

$14.25 - $18.50/hr

Nurse Intern (Varied Shifts) W2 Ortho/Neuro/Trauma - Kingsport, TN - 34540 Holston Valley Medical ... Able to care for patients with varying levels of illness under the direction of an RN. Routine ...

New

Penn Highlands Healthcare

Nurse Intern

Connellsville, PA · On-site

$13 - $17/hr

Connellsville | Allied Health | Part Time Description As a nursing intern, you will learn the fundamentals of nursing under the direct supervision of a registered nurse. Qualifications * Currently ...

Swiss Re

Clinical Risk Manager

Alpharetta, GA · Hybrid

$84K - $140K/yr

Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...

Swiss Re

Clinical Risk Manager

Windsor, CT · Hybrid

$84K - $140K/yr

Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...

Swiss Re

Clinical Risk Manager

Windsor, CT · On-site

$84K - $140K/yr

Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...

Swiss Re

Clinical Risk Manager

Schaumburg, IL · Hybrid

$84K - $140K/yr

Minimum of Associate or Bachelor's degree in nursing with at least 1 year of Stop Loss Nursing experience * Must have up to date registered nurse (RN) license * Able to demonstrate a track record of ...

TidalHealth

Nurse Intern

Berlin, MD · On-site

$14.25 - $18.50/hr

Under the supervision of a Registered Nurse, interns will provide routine direct patient care ... Nurse Intern Position Requirements * Must be a current nursing student going into their senior year ...

TidalHealth

Nurse Intern

Berlin, MD

$17.74 - $25.72/hr

Under the supervision of a Registered Nurse, interns will provide routine direct patient care ... Nurse Intern Position Requirements * Must be a current nursing student going into their senior year ...

TidalHealth

Nurse Intern

Berlin, MD · On-site

$17.74 - $25.72/hr

Under the supervision of a Registered Nurse, interns will provide routine direct patient care ... Nurse Intern Position Requirements * Must be a current nursing student going into their senior year ...

Genesis HealthCare

$15 - $19.50/hr

Under the delegation and supervision of the registered nurse, the Student Nurse Intern will administer basic, direct and/or indirect patient care and perform various procedures and related services ...

Genesis HealthCare System

Student Nurse Intern

Zanesville, OH · On-site

$14 - $18/hr

Under the delegation and supervision of the registered nurse, the Student Nurse Intern will administer basic, direct and/or indirect patient care and perform various procedures and related services ...

Firelands Health

Nurse Intern, ER Bellevue: PRN

Bellevue, OH · On-site

$14 - $18.25/hr

An RN must be identified to precept the nurse intern seeking RN licensure. An LPN or RN may precept a nurse intern seeking LPN licensure. * Review nurse intern documentation. * Direct supervision of ...

previous pagenext page

Showing results 21-40

All Jobsinternship JobsIntern Stop Loss Rn Jobs

Intern Stop Loss Rn information

See salary details

$9

$16

$22

How much do intern stop loss rn jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for intern stop loss rn in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What does an Intern Stop Loss RN do?

An Intern Stop Loss RN assists with managing stop loss insurance claims, which are policies that protect organizations from extremely high claims by covering costs above a certain threshold. They typically help review medical records, coordinate with healthcare providers, and support the reporting and documentation process. Under supervision, they may also learn about claims adjudication, compliance requirements, and data analysis related to stop loss cases. This role is ideal for nursing students or recent graduates interested in healthcare administration or insurance.

What types of projects or learning experiences can an Intern Stop Loss RN expect during their internship?

As an Intern Stop Loss RN, you can expect to be involved in projects that focus on reviewing medical claims for accuracy, learning about risk assessment processes, and supporting the evaluation of complex medical cases. You will often work closely with experienced Stop Loss RNs, underwriters, and claims analysts to understand how clinical knowledge informs insurance decisions. This hands-on experience provides valuable exposure to both clinical and administrative aspects of healthcare, helping you develop skills in case management, data analysis, and interdepartmental collaboration. The internship is structured to provide mentorship and feedback, fostering your growth toward more advanced roles in medical review or insurance nursing.

What are the key skills and qualifications needed to thrive as an Intern Stop Loss RN, and why are they important?

To thrive as an Intern Stop Loss RN, you need a solid understanding of clinical nursing principles, case management, and insurance fundamentals, typically supported by an active RN license. Familiarity with healthcare management software, claims processing systems, and utilization review tools is often required. Strong analytical thinking, attention to detail, and effective communication skills help you assess cases and coordinate with providers and insurers. These abilities are crucial for ensuring accurate claims review, cost containment, and maintaining compliance within the stop loss insurance process.

What is the difference between Intern Stop Loss Rn vs Intern Case Manager?

AspectIntern Stop Loss RnIntern Case Manager
CredentialsRN license, internship or related certificationRN license, internship or related certification
Work EnvironmentInsurance companies, healthcare plans, risk managementHealthcare facilities, insurance companies, patient advocacy
Industry UsageRisk management, insurance, healthcarePatient care coordination, insurance, healthcare

Both roles typically require RN licensure and involve healthcare settings, but Intern Stop Loss Rn focuses on managing insurance risk and stop-loss policies, while Intern Case Manager emphasizes patient care coordination and case management. Understanding these differences helps clarify career paths and job expectations within healthcare and insurance industries.

What are the most commonly searched types of Stop Loss Rn jobs?

The most popular types of Stop Loss Rn jobs are:

Intern Stop Loss Rn jobs near you

Senior Claims Analyst - Hospital Bill Review

SmartLight Analytics

Plano, TX • Remote

$85K - $105K/yr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

We are seeking an experienced Senior Claims Analyst with deep expertise in hospital claims adjudication, stop loss reporting, high-cost/catastrophic claims, and DRG (Diagnosis-Related Group) reimbursement methodology. This individual will analyze itemized hospital bills and claims data to identify billing errors, coding discrepancies, DRG misassignments, and other overpayment opportunities, then work directly with claims administrators on behalf of our ASO clients to secure claim adjustments, recoveries, and repricing.
This is a highly analytical, client-facing role requiring both technical claims expertise and strong negotiation/communication skills.
Key Responsibilities
Claims Analysis & Review
  • Perform detailed audits of hospital and facility claims, including itemized bills, UB-04 claim forms, medical records, and remittance advices, to validate billing accuracy.
  • Analyze DRG assignments and coding to identify DRG upcoding, unbundling, duplicate billing, and other irregularities that affect reimbursement.
  • Review high-cost and catastrophic claims (typically $100K+) to identify overpayments, contract misapplication, and opportunities for negotiated adjustments.
  • Evaluate claims against plan documents, provider contracts, reference-based pricing methodologies, and CMS guidelines to determine appropriate reimbursement.
Stop Loss & High-Cost Claims Expertise
  • Understand and apply stop loss (specific and aggregate) provisions, laser terms, and reporting requirements as they relate to claim adjustments and client financial exposure.
  • Coordinate with stop loss carriers and reinsurers as needed to ensure adjustments and recoveries are properly reflected in stop loss reimbursement calculations.
  • Identify claims nearing or exceeding specific deductible thresholds and prioritize review accordingly.
Client Advocacy & Claims Administrator Negotiation
  • Serve as the subject matter expert and advocate on behalf of ASO clients in disputes with claims administrators (TPAs) and carriers regarding claim payment accuracy.
  • Prepare clear, well-documented findings packages (clinical, contractual, and coding rationale) to support requested claim adjustments and appeals.
  • Lead or support negotiations with claims administrators to reach adjusted payment resolutions.
  • Track disputes through resolution, escalating unresolved cases appropriately and maintaining strong working relationships with TPA claims and provider relations teams.
Data & Reporting
  • Analyze large claims data sets to identify trends, outlier claims, and systemic overpayment patterns across client populations.
  • Build and maintain claim tracking logs, savings reports, and client-facing summaries of identified and recovered savings.
  • Partner with internal data/analytics teams to refine claim-flagging logic and improve identification of high-value review opportunities.
Required Qualifications
  • 5+ years of experience in hospital claims analysis, medical bill review, claims auditing, or payment integrity, with direct exposure to self-funded/ASO plans.
  • Strong working knowledge of DRG methodology (MS-DRG/APR-DRG), UB-04 billing, ICD-10-CM/PCS, CPT/HCPCS coding, and hospital chargemaster structures.
  • Demonstrated understanding of stop loss insurance, including specific/aggregate deductibles, laser provisions, and how claim adjustments impact stop loss reimbursement.
  • Experience analyzing high-cost/catastrophic claims and identifying overpayment or billing error patterns.
  • Prior experience interacting with or negotiating against TPAs, insurance carriers, or claims administrators on disputed claims.
  • Proficiency with claims data analysis tools (Excel required; SQL, Access, or claims analytics platforms a plus)
  • Excellent written and verbal communication skills, with the ability to build persuasive, well-supported adjustment requests and appeals.
  • Strong attention to detail and ability to manage a high volume of complex claims simultaneously.
Preferred Qualifications
  • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Medical Bill Review Specialist, or similar credential.
  • Prior experience at a TPA, insurance carrier, hospital billing/coding department, or payment integrity/cost containment vendor.
  • Familiarity with reference-based pricing (RBP), Medicare fee schedules, and out-of-network claims repricing.
  • Nursing background (RN) or clinical coding background is a plus for clinical validation of DRG and medical necessity issues.
What Success Looks Like
  • Consistent identification of material overpayments and billing errors on high-cost hospital claims.
  • Strong track record of securing favorable claim adjustments through negotiation with claims administrators.
  • Clear, professional communication that strengthens client trust and TPA relationships.
  • Measurable contribution to client savings and stop loss cost containment.

Powered by JazzHR

UkvtOCPvto