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Rn Insurance Assessment Jobs in Rochester, MI (NOW HIRING)

Freedom At Home

Registered Nurse (RN)

Troy, MI

$55 - $65/hr

Complete OASIS assessments and clinical documentation accurately and on time. * Monitor patient ... Valid driver's license, reliable transportation, and auto insurance. Why Freedom at Home? At ...

Aveanna Healthcare

Registered Nurse (Rn)

Troy, MI · On-site

... Company-Paid Life Insurance • Paid Time Off Available • Flexible scheduling- full-time, ... assessments, nursing actions, responses and coordination of care in a timely manner whenever care ...

Brighton Hospice

Registered Nurse (RN)

Novi, MI · On-site

... Vision insurance Paid Time Off 401k plan with employer match and 100% vesting after 90 days of ... regarding psych-social assessments, interventions, and knowledge of community sources. The ...

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Rn Insurance Assessment information

What is an RN Insurance Assessment?

In an RN insurance assessment job, your duties include patient interaction, health care assessment, community education, and medical treatment and claims review. Titles include working as an RN insurance assessor, long term care assessor, Medicare wellness specialist, and UAS RN. Your responsibilities vary depending on your specific position. You may help patients understand their treatment options or health care plans, assess what types of treatments your patients need or are eligible for, and review loss claims on behalf of the insurance company.

What are the key skills and qualifications needed to thrive as an RN Insurance Assessment nurse?

To thrive as an RN Insurance Assessment nurse, you need a valid RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with electronic medical record (EMR) systems, insurance guidelines, and coding tools like ICD-10 is typically required. Excellent communication, critical thinking, and attention to detail are crucial soft skills for accurately evaluating medical information and collaborating with both patients and insurance teams. These skills ensure precise assessments, compliance with regulations, and effective coordination of care and benefits for clients.

What are some common challenges faced by RNs conducting insurance assessments, and how can these be managed?

RNs in insurance assessment roles often encounter challenges such as gathering accurate and complete patient information remotely, navigating complex policy requirements, and balancing workload with timely report submission. To manage these challenges, it's important to develop strong communication skills for effective patient interviews, stay updated on regulatory and policy changes, and utilize available digital tools to streamline documentation. Collaboration with other healthcare professionals and insurance teams also helps ensure assessments are thorough and compliant.

What is the difference between Rn Insurance Assessment vs Rn Case Manager?

AspectRn Insurance AssessmentRn Case Manager
CertificationsRN license, insurance assessment trainingRN license, case management certification
Work EnvironmentInsurance companies, telehealth, home assessmentsHospitals, clinics, insurance companies
Primary FocusEvaluating medical claims for insurance purposesCoordinating patient care and services

Rn Insurance Assessment specialists focus on evaluating medical claims and determining insurance coverage, often working in insurance companies or remotely. Rn Case Managers coordinate ongoing patient care, working closely with healthcare providers and patients. While both roles require an RN license and related certifications, their daily tasks and work environments differ significantly, with insurance assessments centered on claims evaluation and case management on patient care coordination.

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Rn Insurance Assessment jobs near you
Infographic showing various Rn Insurance Assessment job openings in Rochester, MI as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

MICHIGAN Registered Nurse REMOTE - Patient Assessment

J&B Medical Supply Co Inc

Wixom, MI • On-site

$35/hr

Full-time

PTO

Re-posted 13 days ago

Job description

Description:

REMOTE - MUST HAVE VALID MICHIGAN RN LICENSE Our Nursing Team is growing! Great Benefits after 30 days! PTO & Holiday Pay after 90!


Summary: Our Staff Nurse's are responsible for conducting patient assessments by phone (ours) to determine individual needs for incontinence supplies.


ARE YOU READY TO MAKE A MOVE? APPLY NOW! NEW HIRE ORIENTATION STARTS SEPTEMBER 9TH

***** EQUIPMENT IS NOT PROVIDED FOR REMOTE STAFF, YOU MUST HAVE YOUR OWN COMPUTER.


Essential Functions

  • Consults by phone with client, primary caregiver, primary care physician or specialist, case managers and other community resources to determine if client qualifies for a particular program.
  • Expectation is that Nurse will complete 20-25 assessments daily, on average with 98% accuracy.
  • Conducts clinical assessments by phone and documents the client’s medical history. Monitors success rates. All products ordered must be assessed for use and quantity needs per day.
  • Identifies appropriate product and quantity needs based on assessment. If formulary product will not meet needs, then reviews needs and potential solutions with Nurse Manager.
  • Reassesses if there is a change in a client’s medical condition or an increase in quantity request.
  • Obtains prior authorization from the state contract administrator for off-formulary or over-quantity requests.
  • Reviews letters of medical necessity to determine if client qualifies for product or quantity requested.
  • Reviews accounts for accuracy, reporting any errors to the appropriate department manager/leader.
  • Participates in after-hours emergency call rotation.
  • Understanding of insurance guidelines.
  • Utilize intranet tools to complete assessments.
  • Provides education to other J & B employees or external clients regarding products.


Position Type

This is a full time REMOTE or in office position 40 hours per week. Monday through Friday, hours of work vary between 8:00am to 6:00pm. Occasional early mornings, evening and weekend work may be required as job duties demand.

Requirements:
  • Current Registered Nursing License (RN) with the State of Michigan (MI ONLY - CNL'S ARE NOT ACCEPTED)
  • 2+ years previous work experience demonstrating patience, compassion and strong communication skills
  • Must be great on the computer, able to use multiple databases simultaneously

Preferred Education and Experience

  • 3 years of nursing experience
  • Knowledge of medical terminology
  • Medicare and Medicaid background
  • Durable Medical Equipment (DME)

Other Duties

All other duties as assigned by management. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are request of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.