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Nurses In Insurance Jobs in Buffalo, NY (NOW HIRING)

LPN

Niagara Falls, NY · On-site

$22.78 - $27.51/hr

Medical, Dental, Vision, Life Insurance, Supplemental Insurances, 401k, Tuition Assistance and Paid ... Participates in quality improvement activities * Communicates effectively with patients and staff

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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 much do insurance RNs make?

Insurance RNs typically earn between $60,000 and $85,000 annually, depending on experience, location, and certifications. They often work in claims review, risk assessment, or case management, utilizing their nursing skills in an insurance setting.

How to make 150,000 as a nurse?

Nurses can earn $150,000 by gaining advanced certifications, such as Nurse Practitioner or Nurse Anesthetist, working in high-demand specialties, or in roles with overtime and shift differentials. Working in urban areas, hospitals, or private practices with higher pay scales can also increase earnings, especially with experience and additional responsibilities.

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 regulations, often using clinical knowledge and documentation skills. Certification as a registered nurse (RN) is usually required for this role.

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 licensed practical nurse (LPN) or registered nurse (RN).

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 Buffalo, NY? For Nurses In Insurance jobs in Buffalo, NY, the most frequently searched job titles are:
What cities near Buffalo, NY are hiring for Nurses In Insurance jobs? Cities near Buffalo, NY with the most Nurses In Insurance job openings:
Infographic showing various Nurses In Insurance job openings in Buffalo, NY as of June 2026, with employment types broken down into 67% Full Time, 22% Part Time, and 11% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.

$44 - $48.30/hr

Full-time

Posted 6 days ago


Job description

New Rate: (Starting Rate: $44/hr - Up to $46/hr W/ Shift Diff $48.30/hr)

We offer the Following:

  • Premium Compensation
  • Great Benefits Package
  • Professional Growth & Stability

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

RESPONSIBILITIES:

· Monitor the daily delivery of nursing care and nursing staff performance as they deliver nursing care to the patients/residents in accordance with established policies and procedures

· Plan and conduct shift staff meetings on a regular basis to assist in identifying and correcting problem areas and to assist in the improvement of services

· Identify problems or potential problems in the delivery of nursing care to residents and implement corrective action immediately

· Make written and oral reports/recommendations to the Director of Nursing as necessary

· Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the resident's total regimen of care

· Begin investigation of all accidents, including staff interviews, data gathering and report writing

· Interpret the nursing department's policies and procedures to personnel, resident, visitors, and government agencies as required

· Ensure staff always maintain confidentiality of resident information

· Develop work assignments and/or assist in completing and performing such tasks

· Delegate to each Charge Nurse the administrative authority, responsibility, and accountability necessary to perform his/her assigned duties

· Make daily rounds of assigned units at a minimum at the beginning and end of the shift, depending upon the activity of the units

· Follow-up on complaints and grievances filed by resident, families, or staff. Take corrective action as needed and make reports to the Director of Nursing

· Ensure that emergency equipment/supply checks are done each shift

· Ensure that the resident's environment is maintained in a clean and safe manner

· May make determination of death when necessary

· Participate in the orientation program for new assigned nursing staff to facilitate their assimilation into the workplace within a reasonable time span and to ensure that each staff member understands his/her role, responsibilities and standards of performance

· Complete written performance evaluations on the assigned staff following probation and thereafter annually, and when performance dictates the need, complete additional evaluations

· Initiate corrective and progressive disciplinary action, as needed

· Ensure that nursing personnel are performing their work assignments in accordance with acceptable nursing standards

· Ensure that all nursing service personnel comply with the policies and procedures, including dress code as set forth in the Nursing Procedure Manual

· Ensure that an enough nursing staff are scheduled and available for your/next tour of duty to ensure that quality care is maintained, and nursing care needs of the patient/resident are met

· Monitor time and attendance of nursing personnel and take corrective action as appropriate

· Make recommendations to the Director of Nursing regarding employee dismissals, transfers etc.

· Identify learning needs of the nursing staff

· Plan, schedule and conduct unit-based in-services as needs are identified

· Monitor assigned personnel to ensure that they are following established procedures in the use of equipment

· Recommend to the Director of Nursing the equipment and supply needs of the department

· Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste

· Ensure the prompt repair or replacement of medical/nursing equipment when necessary

· Oversee the nursing care to patients/residents to ensure safe, efficient, and customer-oriented services are always delivered.

· Inform nursing staff of new admission arrivals and the expected time of arrival

· Ensure that rooms are ready for the new admission

· Visit resident on report daily to observe and evaluate each resident's physical and emotional status

· Review the nurse's notes to ensure that they are informative and descriptive of the nursing care being provided

· Provide direct nursing care as necessary

· Start and restart IV’s when ordered and when necessary

· Ensure the staff refer to the resident's care plan prior to administering care to the resident

· Assist the staff nurses in monitoring seriously ill resident

· Ensure that all nurses on your shift comply with the written procedures for the administration, storage and control of medications and supplies

· Monitor medication passes and treatments to ensure compliance with physician orders and facility policy

· Review medication administration records (MAR) for completeness of information, accuracy in the transcription of physician orders

· Inspect nursing treatment areas daily, such as clean utility room, to ensure that they are maintained in a clean and safe manner

· Meet with family members and resident as needed.

· Consult with the resident, family, and physician in planning the resident's care, treatment and rehabilitation

· Assist in arranging transportation for transfers to the hospital

· Participate in the implementation of facility quality improvement program for the nursing service department

· Participate in facility surveys (inspections) made by authorized government agencies as requested by the Administrator or Director of Nursing

· Attend and actively participate in various committee meetings such as Infection Control, Safety, and Performance Improvement as requested

· Implement recommendations from committees as instructed by the Director of Nursing

· Perform Performance Improvement audits as assigned

· Participate in and adhere to employee health, safety, security and corporate compliance programs and activities

· Participate in the implementation and maintenance of the Infection Control program for monitoring and/or reporting communicable and/or infectious diseases among resident and personnel

· Assist in developing safety standards for the nursing service department as necessary

· Ensure that personnel follow the established procedures for the use and disposal of personal protective equipment

· Report malfunction of equipment and/or broken furniture immediately to Maintenance Department

· Receive annual physical including appropriate screening for tuberculosis

· The ability to conduct all activities within the resident abuse prevention manual

· Cooperate with investigations regarding employee health, safety, security, and corporate compliance programs

· Report all accident and incidents to Supervisor immediately upon occurrence

· Correct unsafe or hazardous condition encountered, if unable to correct, report condition to immediate Supervisor upon discovery

· Conduct all activities within established safety, security and infection control procedures and guidelines Conducts all activities within established corporate compliance policies and procedures

· Observe and respond to all standing security precautions, devices, and alerts as they pertain to work and common area

· Respond to fire/disaster drills and emergencies

· Ensure residents safety in accordance with resident safety program.

· Follow safety features of the plan of care

· Ensure that all personnel performing tasks that involve potential exposure have attended the appropriate in-service training prior to performing such tasks

· Ensure that the assigned nursing personnel follow established infection control procedures when isolation precautions become necessary

· Ensure that personnel follow the established procedures for the use and disposal of personal protective equipment

· Ensure that all residents are wearing appropriate identification bracelets

· Participates in mandatory in-service and job training

· Assist the Director of Staff Development in providing off shift in-services as necessary

· Assist in the Quality Assurance and Performance Improvement (QAPI) process

QUALIFICATIONS:

EDUCATION / EXPERIENCE:

· Bachelor of Science in Nursing (preferred)

· Current registration and license to practice as a Registered Nurse in the state employed in

· Peripheral IV certification

· Two years of clinical nursing experience

· One-year experience in a management position preferred

· One-year experience in geriatrics and subacute population

New Rate: (Starting Rate: $44/hr - Up to $46/hr W/ Shift Diff $48.30/hr)

We are an Equal Opportunity Employer –M/F/D/V

ACKNOWLEDGEMENT

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. All pay rates and bonuses are paid and/ or awarded to employees based on the facilities policy and/ or the CBA, depending on the position.

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