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Nurses In Insurance Jobs (NOW HIRING)

DenMar Health and Rehab

LICENSED NURSE

Rockport, MA · On-site

Looking for a motivated, hard working, caring individual who works well in a team and alone. We are a COVID FREE nursing facility We offer great Medical, Dental, Vision and Life Insurance for all FT ...

Riverside Health System

LPN - Home Health

Accomac, VA · On-site

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside Health System

LPN - Home Health

Newport News, VA · On-site

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside Health System

LPN - Home Health

Newport News, VA · On-site

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside Health System Non-Providers

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside

$28.50 - $39/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside Health System

LPN - Home Health

Newport News, VA · On-site

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside Health System Non-Providers

$28.50 - $39/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

Riverside

LPN - Home Health

Newport, VA · On-site

$25.80 - $35.48/hr

Has working knowledge of Medicare, Medicaid and insurance requirements, agency Policies and ... Assists the physicians/registered nurses in the care of clients in their homes through provision of ...

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All JobsNurses In Insurance Jobs

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.
More about Nurses In Insurance jobs
What cities are hiring for Nurses In Insurance jobs? Cities with the most Nurses In Insurance job openings:
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What job categories do people searching Nurses In Insurance jobs look for? The top searched job categories for Nurses In Insurance jobs are:
Nurses In Insurance jobs near you
Infographic showing various Nurses In Insurance job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, 1% Temporary, and 4% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Claim Specialist - Large Loss

Church Mutual Insurance, S.I.

Remote

Full-time

Re-posted 21 hours ago

Job description

BASIC PURPOSE:
In accordance with application of state and federal laws and company best practices, handle higher exposure, complex claims within an assigned line of coverage including multi-jurisdictional and litigated matters. Gather and review claim information, determine coverage, and conduct investigation. Initiate and maintain customer contact to provide updates and resolve any issues with the claim. Update information in the claim system to document claim handling activities. Determine/set reserves and make payments within level of authority. Investigate and refer identified claims to Loss Recovery Services as applicable. This role requires knowledge of coverage forms and claims handling for General Liability (GL), Auto Liability, Professional Liability (PL), Employment Practices Liability (EPL), and Directors & Officers (D&O) lines of business.
PRIMARY JOB RESPONSIBILITIES:
  • Perform claim tasks timely and document claim files appropriately. Proactively manage claim activities to ensure fair claim resolution. Handle all claims in accordance with state and federal laws.
  • Make complex coverage decisions by gathering information necessary to make an informed decision in a fair, equitable, and ethical manner. Provide detailed explanation, citing facts, and relevant policy language. Evaluate subrogation potential based on the applicability of policy language and/or governing state laws and statutes as appropriate.
  • Perform a thorough investigation based upon the type, complexity, and severity of the claim. Upon completion of the investigation, analyze and evaluate the potential exposure and damages, including potential full or partial liability, compensability denials, and subrogation potential as applicable. Formulate and document an action plan based on the covered damages and injuries.
  • Determine and set reserves based upon a risk-neutral evaluation of the most likely outcome within authority level. Evaluate and negotiate directly with insured, claimant, or claimant's attorney on all cases within authority level. Review claim facts and exposure with claims management as appropriate, to guide claim strategy. Make complete, accurate, and timely loss and/or expense payments within authority for covered losses. Refer claims above authority to appropriate team member for review and potential reassignment.
  • Maintain a professional, courteous, and helpful approach when communicating in person, on the phone, or through email and other correspondence with internal and external customers, business partners and brokers
  • Recognize when vendor partners are required on a claim, including experts, independent adjustors, nurses, defense attorneys, etc. Assign and direct vendors, as needed, to aid in the investigation and evaluation of the claim. Manage claim expense by reviewing attorney/firm performance, results and the value of services provided.
  • Investigate and refer identified claims to Loss Recovery Services as applicable.
  • Attend mediations and other litigation-related activities as needed
  • Collaborate with defense counsel and direct litigation strategy.

QUALIFICATIONS:
  • Bachelor's degree preferred. A combination of equivalent education and/or experience may be considered in lieu of a degree.
  • Additional training in insurance, medical, and/or legal environments is desirable.
  • Completion of INS, AIC, or CPCU is preferred.
  • Minimum of five years of claim handling and/or other insurance-related experience is required.
  • General Liability and/or Professional Liability experience preferred
  • Ability to obtain and maintain state adjusting license requirements and complete continuing education requirements.
  • Evidence of ability to think independently.
  • Strong listening, verbal, and written communication skills.
  • Ability to handle multi-jurisdictional and litigated claims.
  • Proficient knowledge of policy terminology and legal principles involving at least one or more of the following: insurance, automobile, medical and litigated claims.

WORK ENVIRONMENT:
  • Professional office environment.

NOTE: This job description in no way states or implies that these are the only duties performed by this employee. Employees may be requested to perform job-related tasks other than those specifically presented in this job description. The employer reserves the right to change or assign other duties to this position.
The CM Group is made up of Church Mutual Insurance Company, S.I., CM Regent Insurance Company, CM Vantage Specialty Insurance Company and CM Select Insurance Company.
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