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Stop Loss Rn Jobs in Illinois (NOW HIRING)

Hallmark of Pekin

Registered Nurse RN

Pekin, IL · On-site

Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...

Hallmark of Pekin

Registered Nurse RN

Pekin, IL · On-site

$42 - $50/hr

) Join Our Team as a Registered Nurse (RN) Location: Hallmark Healthcare of Pekin, Pekin, IL Shift ... Apply online or stop by in person today: 2501 Allentown Road, Pekin, IL 61554 Apply Online: We look ...

Avantara Joliet

Registered Nurse, RN

Joliet, IL

$32 - $44.68/hr

If you are an RN with a passion for excellence and a drive to lead, stop in to learn more and get your career started. Avantara Joliet is an equal opportunity employer. All qualified applicants will ...

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Stop Loss Rn information

What are the typical daily responsibilities of a Stop Loss RN?

As a Stop Loss RN, your typical day involves reviewing high-cost medical claims, verifying the medical necessity of treatments, and assessing policy compliance to determine insurance coverage. You’ll collaborate closely with clinical staff, insurance specialists, and sometimes directly with healthcare providers to gather relevant information and ensure accurate case evaluations. Many Stop Loss RNs also prepare detailed reports and participate in case conferences. This role often combines remote desk work with communications across multidisciplinary teams, creating a dynamic environment well-suited for nurses looking to leverage their clinical expertise in an insurance or administrative setting.

What are the key skills and qualifications needed to thrive in the Stop Loss RN position, and why are they important?

To thrive as a Stop Loss RN, you need in-depth clinical nursing experience, a strong understanding of insurance policies and claims, and RN licensure. Familiarity with medical claims adjudication systems, electronic health records, and utilization review platforms is typically required. Excellent communication, critical thinking, and attention to detail set top performers apart in this role. These skills are important to effectively review complex medical cases, ensure appropriate healthcare coverage, and collaborate with both providers and insurers.

What is a Stop Loss RN?

A Stop Loss RN is a registered nurse who reviews medical claims and patient records to evaluate the necessity, accuracy, and cost of healthcare services for insurance companies or employers. They help determine whether claims exceed stop-loss insurance thresholds, which protect insurers or self-funded employers from excessive financial risk. This role involves assessing medical necessity, verifying coding accuracy, and collaborating with case managers, providers, and insurance teams. Strong analytical skills and clinical expertise are essential for making informed decisions on high-cost claims.

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Stop Loss Rn jobs near you

RN (Registered Nurse)

Carilion Roanoke Memorial Hospital

Quincy, IL • On-site

$2.3K/wk

Other

Re-posted 8 days ago

Carilion Clinic rating

6.9

Company rating: 6.9 out of 10

Based on 214 frontline employees who took The Breakroom Quiz

452nd of 887 rated healthcare providers

Job description

Details
Client Name
Blessing Hospital
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
ER
Job ID
35523439
Job Title
RN (Registered Nurse)
Weekly Pay
$2326.0
Shift Details
Shift
Night - 12x3 - 07PM
Scheduled Hours
36
Job Order Details
Start Date
08/31/2026
End Date
11/30/2026
Duration
13 Week(s)
Job Description
Job Title: Emergency Room Registered Nurse
Profession: RN
Specialty: Emergency Room
Duration: 13 weeks
Shift: 12H Nights
Hours per Shift: 12 hours
Experience: Minimum of 2 years in Emergency Department nursing
License: Required
Certifications: ACLS, BLS, NIHSS, PALS, TNCC
Must-Have:
- At least 2 years of Emergency Department RN experience
- Required certifications
Description:
Immediate need for an Emergency Room Registered Nurse.
Nurse must be able to start as soon as possible.
Attention: 4 hours of billable computer modules are required prior to start.
The modules will be delivered the week before the start date.
This position involves working in a Level 2 Trauma Center.
The average patient volume is approximately 120 patients per day.
The facility features a 30-bed capacity with a mix of medical and psychiatric beds.
POD nursing is utilized for assignments based on average daily census.
This role is critical for providing high-quality care in an acute setting.
Cancellation policy allows for 3 shifts per 13-week contract or 2 shifts per shorter contract.
Charting will be done using an electronic medical record system.
Client Details
Address
1005 Broadway St
City
Quincy
State
IL
Zip Code
62301
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What Carilion Clinic employees say

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About Carilion Clinic

Sourced by ZipRecruiter

This is Carilion Clinic ... An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious. Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute. Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Roanoke, VA, US

Year founded

1899

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