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Nurses In Insurance Jobs in Hubertus, WI (NOW HIRING)

Solicitude, Inc.

Live In Caregiver

Milwaukee, WI · On-site

$760 - $880/wk

... A CNA will make $880 per week *We are currently offering a $500 Signing Bonus, paid out after 4 ... Health insurance benefits available after 60 days of employment** Requirements for this position ...

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Nurses In Insurance information

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.

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 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.

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.

What cities near Hubertus, WI are hiring for Nurses In Insurance jobs? Cities near Hubertus, WI with the most Nurses In Insurance job openings:
Nurses In Insurance jobs near you
Infographic showing various Nurses In Insurance job openings in Hubertus, WI as of May 2026, with employment types broken down into 2% Internship, 2% As Needed, 60% Full Time, 14% Part Time, 20% Contract, and 2% Nights. Highlights an 98% Physical, and 2% Remote job distribution.
Director of Insurance Authorization

Director of Insurance Authorization

Champion Care

Milwaukee, WI • On-site

Full-time

Posted 26 days ago

Job description

) Director of Insurance Authorization - Skilled Nursing (SNF)
Full-Time | Competitive Salary (Based on Experience)
We are seeking an experienced and driven Director of Insurance Authorization to lead our case management and authorization operations across multiple skilled nursing facilities.
This role is responsible for overseeing a team of Case Managers, ensuring timely insurance authorizations, reducing denials, and driving strong clinical and financial outcomes. If you have a strong clinical background and experience working with managed care, this is a high-impact leadership opportunity.
What You'll Do
As the Director of Insurance Authorization, you will oversee the full authorization and case management process while supporting both your team and facility partners.
Key Responsibilities:
  • Lead and manage a team of Clinical Case Managers supporting multiple SNF locations
  • Ensure timely completion of insurance authorizations, updates, and appeals across Medicare, Medicaid, and commercial plans
  • Oversee daily workflows, including admissions, re-admissions, and discharge tracking
  • Monitor payer portals and address insurance concerns, denials, and documentation gaps
  • Conduct daily team check-ins to prioritize work, remove barriers, and drive accountability
  • Support case managers directly on complex or high-priority cases
  • Partner with facility leadership and back-office teams to ensure accurate billing and reimbursement
  • Participate in weekly and monthly authorization and Medicare meetings
  • Develop and deliver training on NOMNCs, ABNs, and managed care processes
  • Stay current on insurance regulations and ensure team compliance
  • Lead hiring, onboarding, and performance evaluations for case management staff
What We're Looking For
  • RN or LPN license highly preferred
  • Experience in insurance authorization, case management, or utilization review within SNF or post-acute care
  • Strong knowledge of Medicare, Medicaid, and managed care processes
  • Proven leadership experience managing teams in a healthcare setting
  • Ability to oversee multiple facilities, priorities, and deadlines
  • Strong communication and problem-solving skills
  • Highly organized with a focus on execution and accountability
Why Join Us
  • High-impact leadership role tied directly to revenue, census, and clinical outcomes
  • Opportunity to build, lead, and scale a high-performing team
  • Growth within a multi-facility healthcare organization
  • Collaborative and fast-paced environment

Champion Care is an Equal Opportunity Employer (EOE). We are committed to creating an inclusive environment for all employees and applicants and do not discriminate based on race, color, religion, sex, national origin, age, disability, genetic information, or any other protected status.
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