CI Nurse Reviewer

MetLife, a leading provider of insurance and other financial services to individual and institutional customers, is seeking a CI Nurse Reviewer in Bridgewater, NJ! Beyond meaningful and challenging work, MetLife provides a variety of flexible work arrangements, as well as a tuition reimbursement program, competitive benefits, and retirement and pension plans. MetLife’s responsiveness to the needs of both clients and employees is a direct result of one of the core company values– People Count. Major Duties and Functions Include: Acts as a member of the Critical Illness claims department specializing in the medical review of submitted claims. Provides benefits to its policy holders for the first time occurrence for any one of the following: Heart Attack, Stroke, Coronary Artery Bypass Grafting, Kidney Failure, Major Organ Transplants, and Cancer. Responsibility within the claims department spans from requesting appropriate medical; records from hospitals and private medical practices; reviews, records, and analyzes medical records; applies specialized training/knowledge to the assessment of cases; provides technical insight: to making recommendations on Critical Illness claim benefit decisions. What You Need to Succeed: Current RN licensure with minimum of 3-5 years experience in any of the following areas: cardiac, oncology, internal medicine, emergency room care. Very strong understanding of medical terminology, human biology, anatomy and common medical conditions. Ability to read and understand a medical assessment based on review of medical records. Medical Records include but are not limited to (pathology reports, clinical notes, hospital notes, surgical notes, laboratory findings, cardiac catheterization findings, EKGs, MRI/MRA findings, and death certificates.) BSN preferred. Must have skills in problem solving, negotiating, and time management. Must have resourcefulness, diplomacy, creativity and objectivity in handling various assignments and the ability to work in a team environment. Assist in the continuous review, update and/or revision of the claims manual. Research obscure medical conditions and provide cogent analysis. Maintain current, in depth knowledge of medical literature via on-going journal review and attendance of select industry and non-industry medical conferences. Self motivated and able to work without close supervision. Well developed relationship building {interpersonal, communication, collaboration} skills. Exhibits flexibility and sensitivity in a dynamic business environment. Exceptional written and oral communications. Work shouldn’t be something you do just to make ends meet. It should provide satisfaction…and an opportunity to make a difference. MetLife… where work meets life!Do YOU have what it takes to join a Major Force in Financial Services: Investments, Financial Advice, Banking and Insurance? If so respond TODAY! For immediate consideration, please APPLY NOW to submit your resume!MetLife is an Equal Opportunity Employer. Additional Information Position Type:  Full Time, Employee Ref Code:  20385 Number of Openings: 1 Business Area: Institutional Travel paid for interviews? NO Relocation expenses paid? NO Percent of travel on the job: 5-15 Salary Grade: 29 Company Code: Metropolitan Life Insurance Co. View all "MetLife" jobs