New York Licensed Clinical Underwriter

Job Summary

A company is looking for a Clinical Underwriter to assess medical risk and manage financial risk for claims.

Key Responsibilities

• Assess medical risk for claimants using available information and guidelines
• Review and analyze large claim reports and clinical information from various sources
• Provide clinical opinions and recommendations to support financial risk management and clinical cost containment

Required Qualifications, Training, and Education

• Associates degree; Bachelor's degree preferred with experience as a substitute
• Active, unrestricted Nursing License (RN or LPN) required
• 4 - 6+ years of relevant work experience, including medical underwriting or risk management
• Three years of direct clinical experience, preferably in acute care
• Knowledge of ICD 10 coding and medical terminology, as well as state and federal regulations related to underwriting