Registered Nurse RN
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Quick apply
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
$37 - $40/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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
$37 - $40/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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Quick apply
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Mount Vernon, IA · On-site
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. Hallmark Care Center is an equal opportunity employer. All qualified applicants ...
Aplington, IA · On-site
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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Aplington, IA · On-site
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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
$36 - $42.50/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. Oelwein Healthcare Center is an equal opportunity employer. All qualified ...
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$36 - $42.50/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. Oelwein Healthcare Center is an equal opportunity employer. All qualified ...
Aplington, IA · On-site
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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Aplington, IA · On-site
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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
Clear Lake, IA · On-site
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. Oakwood Care Center is an equal opportunity employer. All qualified applicants ...
$34 - $40/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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Quick apply
$34 - $40/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. Maple Manor Village is an equal opportunity employer. All qualified applicants ...
Garner, IA · On-site
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
Garner, IA · On-site
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
Oelwein, IA · On-site
$36 - $42.50/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. Oelwein Healthcare Center is an equal opportunity employer. All qualified ...
Oelwein, IA · On-site
$36 - $42.50/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. Oelwein Healthcare Center is an equal opportunity employer. All qualified ...
$37 - $40/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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Quick apply
$37 - $40/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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
Quick apply
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Marshalltown, IA · On-site
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. Harmony Marshalltown is an equal opportunity employer. All qualified applicants ...
Garner, IA · On-site
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
Garner, IA · On-site
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. Concord Care Center is an equal opportunity employer. All qualified applicants ...
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.
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.
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.

Full-time
Retirement
Re-posted 11 days ago
5.9
Based on 55 frontline employees who took The Breakroom Quiz
759th of 887 rated healthcare providers
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance
5,001 - 10,000 Employees
Skokie, IL, US
2008