Job Summary

Nurse Reviewer / Claims Analyst (RN)

  • Location:
    Beaverton, Oregon
  • Job reference:
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Nurse Reviewer / Claims Analyst
Beaverton OR
12 month contract

The Claims Analyst 3 – Nurse Reviewer (CA3) works on the full range of claims, correspondence, quality assurance and escalations to ensure the satisfaction of the goals and priorities of the team. The CA3 also does their part to meet expectations of internal and external clients with respect to claim handling and Service Level Agreements.
Our client is a global legal services organization that emphasizes technological solutions to our clients’ legal needs. The Beaverton office specializes in the administration of class action settlements, mass torts, and similar legal matters that impact large populations of potentially injured parties.
Job Responsibilities
• Follows written procedures and scripts
• Consults with team leadership and peers on case work
• Uses proprietary software tools to access and review claim documents, enter claim decisions, and create escalations when needed
• Communicates immediately to leadership all obstacles to completing work
• Meets and exceeds departmental expectations for accuracy and productivity
• Contributes subject area expertise to determine processing guidelines and assess if standards have been met
• Utilizes documented team processes to ensure compliance with departmental standards
• Data entry and verification
• Drafts claimant facing communications based on guidance provided
• Communicates directly with claimants by phone or email
• Verifies data and processing requirements and makes corrections as necessary
• Other projects as assigned
• MUST HAVE RN or Associate Degree in Nursing
• Excellent attention to detail
• Strong communication skills, both written and verbal
• Sharp critical thinking skills with sound judgment
• Ability to sit at a computer workstation for long periods of time

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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