Job Description

About us: Berkshire Hathaway GUARD Insurance Companies is a leading small business insurance provider nationwide. We offer property & casualty insurance products through an independent agent network. Rated A+ Superior by AM Best, we are owned by Berkshire Hathaway, owned by Warren Buffett. Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals.

Overview

Founded on a culture of accountability, service, integrity, empowerment, and diversity, we seek talented individuals to join our team and pursue an exciting career path.

Benefits

• Competitive compensation
• Healthcare benefits package that begins on the first day of employment
• 401(k) retirement plan with company match
• Generous paid time off and 9 paid holidays
• Up to 6 weeks of parental and bonding leave
• Hybrid work schedule (3 days in the office, 2 days from home)
• Longevity awards every 5 years of employment
• Tuition reimbursement after 6 months of employment
• Numerous opportunities for continued training and career advancement
• And more

Responsibilities

• Support internal claims adjusting staff in the review of workers compensation claims
• Review records and requests for UR received via mail, e?mail, fax, or phone
• Meet required decision?making timeframes
• Clearly document all communication and decision?making within our insurance software system
• Establish collaborative relationships and serve as intermediary between clients, patients, employers, providers, and attorneys
• Utilize good clinical judgment, careful listening, and critical thinking and assessment skills
• Track ongoing status of all UR activity to meet appropriate turnaround times

> Maintain organized clinical documentation files for every claim

• Send appropriate letters on each completed UR

Qualifications

• Active Licensed Practical Nurse or Registered Nurse license
• 1+ year of utilization review experience at a managed care plan or provider organization
• 2+ years of clinical experience, preferably in case management, rehabilitation, orthopedics, or utilization review
• Excellent oral and written communication skills, with outstanding phone presence
• Strong interpersonal and conflict resolution skills
• Experience in a fast?paced, multi?faceted environment
• Ability to set priorities, work independently and as a team member
• Well?developed time?management and organization skills
• Excellent analytical skills
• Working knowledge of Microsoft Word, Excel, and Outlook

Seniority level

• Entry level

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• Insurance

We are an equal opportunity employer that strives to maintain a welcoming and enriching work environment for all.

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