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Nurses In Insurance Jobs in Oregon (NOW HIRING)

PeaceHealth

Referral Coordinator

Springfield, OR · On-site

$25.62 - $34.58/hr

Preferred: Registered Nurse Skills * Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures ...

PeaceHealth

Referral Coordinator

Springfield, OR

$25.62 - $34.58/hr

Preferred: Registered Nurse Skills * Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures ...

Jobs for Humanity

Travel Registered Nurses

Medford, OR · On-site

$2.0K - $2.2K/wk

Host Healthcare TravelNurseSource is working with Host Healthcare to find a qualified Other RN in ... Day one medical, dental and vision insurance. License, travel, tuition, and scrub reimbursement.

Jobs for Humanity

Travel Registered Nurses

Medford, OR · On-site

$2.0K - $2.2K/wk

Host Healthcare TravelNurseSource is working with Host Healthcare to find a qualified Other RN in ... Day one medical, dental and vision insurance. License, travel, tuition, and scrub reimbursement.

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Nurses In Insurance information

What is the difference between Nurses In Insurance vs Insurance Claims Adjusters?

AspectNurses In InsuranceInsurance Claims Adjusters
Required CredentialsRN license, nursing degreeHigh school diploma or equivalent, licensing may be required
Work EnvironmentInsurance companies, healthcare settings, remote optionsFieldwork, office settings, remote work possible
Industry UsageHealth insurance, disability, life insuranceProperty, casualty, health insurance claims
Job FocusAssessing health-related claims, medical reviewsInvestigating claims, determining coverage validity

While Nurses In Insurance focus on medical assessments and reviews within insurance claims, Insurance Claims Adjusters handle the investigation and evaluation of various insurance claims, including property and casualty. Both roles require understanding insurance policies, but Nurses In Insurance have a healthcare background, whereas Claims Adjusters focus more on claim investigation and settlement processes.

How to make $300,000 as a nurse?

Nurses can earn $300,000 by working in high-paying specialties such as nurse anesthetist, nurse practitioner, or clinical nurse specialist, often requiring advanced certifications and experience. Working overtime, taking on leadership roles, or working in private sectors and specialized facilities can also increase income significantly.

What does a nurse do for an insurance company?

A nurse working for an insurance company typically reviews medical records, assesses claims, and determines coverage eligibility based on medical necessity. They may also provide expert opinions, support claims processing, and ensure compliance with healthcare policies, often using clinical knowledge and documentation skills.

How to make an extra 2000 a month as a nurse?

Nurses can earn an extra $2000 a month by taking on per diem or agency shifts, which often pay higher rates, or by working overtime and weekend shifts. Developing specialized skills in areas like IV therapy, anesthesia, or telehealth can also lead to higher-paying side opportunities. Additionally, some nurses supplement income through telehealth consulting or by offering health education services outside regular hours.

Can nurses work in insurance companies?

Nurses can work in insurance companies in roles such as case managers, claims reviewers, or health consultants. These positions often require clinical knowledge, strong communication skills, and sometimes certifications like a Certified Case Manager (CCM).

What are the key skills and qualifications needed to thrive as a Nurse in Insurance, and why are they important?

To thrive as a Nurse in Insurance, you need a solid nursing background, active RN licensure, and experience in case management or utilization review. Familiarity with insurance claims software, medical coding (ICD-10, CPT), and knowledge of healthcare regulations are typically required. Strong analytical, communication, and negotiation skills help nurses effectively review claims and collaborate with patients, providers, and insurers. These competencies ensure accurate claim assessments, cost-effective care, and compliance with regulatory standards in the insurance industry.

What are nurses in insurance?

Nurses in insurance, often called nurse case managers or insurance nurse consultants, are registered nurses who work for insurance companies to review medical claims, assess patient care needs, and coordinate healthcare services. They use their clinical expertise to evaluate treatment plans, ensure medical necessity, and help contain costs while advocating for appropriate patient care. These nurses play a key role in claims management, utilization review, and sometimes help educate policyholders about health and wellness.

How do nurses in insurance typically collaborate with other professionals within the insurance industry?

Nurses in insurance often work closely with claims adjusters, underwriters, medical directors, and case managers to evaluate medical claims, assess risk, and ensure policyholders receive appropriate care. They review medical records, provide clinical insights, and may communicate directly with healthcare providers to clarify treatment details. This collaborative environment requires strong communication skills and the ability to translate clinical knowledge into insurance-related recommendations, making teamwork an essential part of daily responsibilities.
What are popular job titles related to Nurses In Insurance jobs in Oregon? For Nurses In Insurance jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Nurses In Insurance jobs in Oregon look for? The top searched job categories for Nurses In Insurance jobs in Oregon are:
What cities in Oregon are hiring for Nurses In Insurance jobs? Cities in Oregon with the most Nurses In Insurance job openings:
Nurses In Insurance jobs near you
Referral Coordinator

Referral Coordinator

PeaceHealth

Springfield, OR • On-site

$25.62 - $34.58/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

PeaceHealth rating

7.7

Company rating: 7.7 out of 10

Based on 174 frontline employees who took The Breakroom Quiz

157th of 885 rated healthcare providers

Job description

PeaceHealth is seeking a Referral Coordinator for a Full Time, 1.00 FTE, Day position.
The salary range for this job opening at PeaceHealth is $25.62 - $34.58.
The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Job Summary
Assure that the services that are approved by private payors have been done and that we request more visits for patients as we continue through the episode of care. May also be responsible for management of referrals; working closely with team members to ensure optimum utilization and cost containment. Provides clerical support and assistance to staff.
Details of the Position:
  • Oversees the data entry and completion of referral forms/notifications. Obtains insurance pre-authorization for patients and reauthorization of additional treatment. Ensures insurance carrier (including Medicare) documentation requirements are me and referral support documentation is filed in patient's medical record.
  • Efficiently manages correspondence with patients, physicians, specialists, insurance companies. Documents pertinent information on referral form and/or in medical record. Ensures practitioners are following standardized guidelines as recommended by evidenced based medicine.
  • Communicates with billing staff and third-party payors to assure coverage of patient care.
  • Performs other duties as assigned.

What you bring:
  • Accredited School Preferred: Business or two years college And
  • Preferred: Medical Assistant, Licensed Practical nurse, or Registered Nurse
  • Minimum of 3 years Required: Experience working in insurance in a medical related field, or other related experience
  • Preferred: National Certified Medical Assistant or
  • Preferred: Licensed Practical Nurse - Oregon or
  • Preferred: Registered Nurse

Skills
  • Demonstrated experience in insurance requirements for referrals and /or prior authorizations to various therapies (PT, RT, OT, ST), surgeries, procedures, diagnostic testing, and infusions. GYN procedures, testing, etc (Required)
  • Proficient with MS Office applications (Required)
  • Proficient with Horizon Home Care (Required)

Working Conditions
  • Consistently operates computer and other office equipment.
  • Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
  • Sedentary work.
  • Predominantly operates in an office environment.
  • Ability to communicate and exchange accurate information.
  • The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

For additional information or questions, please email Jen Worthington at Jworthington@peacehealth.org or call 360-448-0542.
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

What PeaceHealth employees say

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About PeaceHealth

Sourced by ZipRecruiter

PeaceHealth, based in Vancouver, WA, is a not-for-profit Catholic health system employing approximately 16,000 caregivers, a multi-specialty medical group practice with more than 1,200 providers and 10 medical centers serving both urban and rural communities in Washington, Oregon, Alaska. In 1890, the Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, the legacy of its founding Sisters continues with a spirit of respect, stewardship, collaboration and social justice in fulfilling its Mission. Get a feeling for the Spirit of PeaceHealth through this three-minute video, and visit us on Facebook or LinkedIn! We offer competitive compensation, a robust benefitspackage and a collaborative, Mission-driven work environment! To learn more please visit: jobs.peacehealth.org. Questions? Review our Employment FAQor email Recruitment@peacehealth.org. Please note this email does not accept resumes or applications.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Vancouver, WA, US

Year founded

1890

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