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

Kinney Drugs

Licensed Practical Nurse

Watertown, NY

$25 - $26/hr

Nurse/Clinician will play an active role in compliance to meet insurance guidelines while promoting a healthy sleep lifestyle. * Provides follow up phone calls within the required 72 Hr timeframe for ...

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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 job categories do people searching Nurses In Insurance jobs in Carthage, NY look for? The top searched job categories for Nurses In Insurance jobs in Carthage, NY are:
What cities near Carthage, NY are hiring for Nurses In Insurance jobs? Cities near Carthage, NY with the most Nurses In Insurance job openings:
Nurses In Insurance jobs near you

RN - MDS Manager (Long-Term Care)

NurseAmerica Healthcare

Watertown, NY • On-site

$85K - $100K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 17 days ago

Job description

Job Title: RN – MDS Manager (Long-Term Care)

Location: Watertown, NY

About NurseAmerica:

NurseAmerica is a nationally recognized provider of healthcare workforce solutions committed to placing dedicated nurses in high-quality clinical settings. We proudly serve RNs and LPNs with flexible job opportunities, competitive pay, full benefits and consistent support. Whether you're seeking full-time, part-time, or per diem roles, NurseAmerica offers opportunities that align with your goals while helping healthcare organizations deliver exceptional patient care.

Role Summary:

NurseAmerica is seeking an experienced and detail-oriented MDS Manager (Registered Nurse) in Amherst, NY to join a respected long-term care facility in Watertown, New York. This is an excellent opportunity for a Registered Nurse with strong knowledge of MDS assessments, care planning, and reimbursement systems to lead clinical documentation and compliance initiatives that directly impact quality of care.

The MDS Manager oversees and maintains the current MDS status of each resident in compliance with federal and state regulations under the Omnibus Reconciliation Act, Medicare PPS, and Medicaid payment systems. The role involves coordinating with clinical teams, payers, and families to ensure accurate documentation, optimal reimbursement, and exceptional resident care.

Position Details

  • Position Details
  • Location: Watertown, NY
  • Schedule: Day Shift (Approx. 5:30 AM – 4:00 PM)
  • Employment Type: Full-Time, Permanent
  • Sign-On Bonus: $5,000 (with 2-year commitment)
  • Referral Bonus: Up to $1,000

What You’ll Do:

  • Manage and maintain accurate MDS assessments in accordance with all federal and state regulations
  • Conduct audits to ensure documentation supports clinical, regulatory, and financial needs
  • Serve as liaison among residents, families, providers, and payers for optimal care coordination
  • Lead and educate staff on MDS/RUGs and documentation best practices
  • Participate in surveys, inspections, and audits conducted by authorized agencies
  • Coordinate resident care conferences and ensure interdisciplinary communication
  • Monitor residents at higher risk for extensive or acute care needs

Qualifications

Required:

  • Active Registered Nurse (RN) license in the state of New York
  • Experience in Long-Term Care (LTC) or geriatric nursing
  • Knowledge of PPS, Medicare/Medicaid, and payer regulations
  • Strong understanding of nursing documentation and compliance standards
  • Experience with electronic health record systems and MDS software

Preferred:

  • Registered Nurse Assessment Coordinator (RNAC) certification
  • Background in quality assurance, audits, and appeals processes

Benefits

  • $5,000 Sign-On Bonus (with 2-year work commitment)
  • 401(k) with Employer Match
  • Comprehensive Benefits starting the 1st of the month following 30 days of employment
  • 24 Days of PTO in the first year
  • Life and Long-Term Disability Insurance available

Why Join NurseAmerica?

At NurseAmerica, we connect top nursing professionals with exceptional healthcare facilities nationwide. Our mission is to help nurses find meaningful, rewarding opportunities that align with their skills and career goals — while ensuring our partner facilities receive quality, dependable care staff.

Apply now and make an impact where it matters most! Not for you? Refer a qualified candidate and earn up to $1000!

Questions? Email us: hr@nurseamerica.us

Learn more: www.nurseamerica.us