Hey there! I am an RN specialized in surgery trying to break into remote utilization work, specifically review of insurance claims. Does anyone have experience going from bedside into health insurance with no experience? I have less than a year of nursing experience but ready to make the switch because of working during the pandemic, getting my masters, and crap pay.

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I would start with Utilization and/or case management at the hospital your at. When you interview tell them your interested in remote work after training.

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We screen patients at the bedside and assist in forming a safe dc plan. They may need rehab, nursing home placement, may have to work on getting authorization for those services, medical equipment. We work as an interdisciplinary team with doctor, PT/OT, caregivers, nursing.

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Can you try to get into inpatient case management? You do some UM which helps you transition into full UM for insurance.

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Agree, this would be the way to go.

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What state are you in?

Centene is literally always hiring....you need no case management experience. 85k and up with bonuses.

Utilization has a lot of insurance rules. At my facility if you’ve never done it before remote work is possible after training. They will make sure you can work independently before they turn you loose. It is possible though.

I am willing to train in person if the option for permanent remote work is avaliable after

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