Consultant, Claims Casualty

Nationwide
Des Moines
Workplace: RemoteFull timeUSD 97,000 - 180,000 annuallyFunction: Business OperationsExperience: 7-10 yearsEducation: bachelorsSkills: ["Relationship-building","Project management","Negotiation","Problem-solving","Communication"]

Lead medical cost-containment and workers’ compensation bill-review work, combining medical judgment with coding and billing expertise. Coordinate and prioritize projects, refine bill-review rules, and support escalated reviews through internal queues and tools. Manage vendor relationships, implement process improvements and training, and provide consultative support while analyzing trends to improve billing accuracy, control medical inflation, and preserve claim quality.

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FursaFursa
Nationwide
Nationwide
1 day ago

Consultant, Claims Casualty

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Source: Company careers pageValidated by: Fursa AI
Last checked: 5 hours agoStatus: Live

Job Summary

Lead medical cost-containment and workers’ compensation bill-review work, combining medical judgment with coding and billing expertise. Coordinate and prioritize projects, refine bill-review rules, and support escalated reviews through internal queues and tools. Manage vendor relationships, implement process improvements and training, and provide consultative support while analyzing trends to improve billing accuracy, control medical inflation, and preserve claim quality.
Location: Des Moines
Workplace: Remote
Employment Type: Full time
Job Function: Business Operations
Seniority: Mid level

Key Responsibilities

  • •Coordinate and prioritize project work across planning, communication, execution, and completion.
  • •Develop and control project timelines, risks, and resource/budget cost containment while aligning with business strategy.
  • •Lead business process mapping to correct data quality/integrity issues.
  • •Recommend and implement process, tool, and policy innovations; provide training and serve as point of contact for products.
  • •Manage vendor relationships and act as subject matter authority; respond to internal/customers and regulatory agencies on compliance or data matters.

Pay and Benefits

Salary: USD 97,000 - 180,000 annually
Perks:Health InsuranceDentalVisionLife InsuranceLong-term DisabilityPaid LeavePaid Holidays401kPension Plan

Key Requirements

  • •RN required with coding certificate required; if not currently a coder, certification is expected within the first 6 months.
  • •7 to 10 years of work experience in claims, preferably casualty and litigation area.
  • •Experience with management, facilitation, negotiation, delegation, and mentoring; business process mapping experience preferred.
  • •Knowledge of project management concepts and techniques, business systems, and data processing policies and procedures.
  • •Strong relationship-building, communication, negotiation, and data quality/integrity problem-solving skills; able to influence senior leaders.
Experience:7-10 yearsInsuranceClaimsCasualtyLitigationWorkers' compensation
Education:Bachelor's
Skills:Relationship-buildingProject managementNegotiationProblem-solvingCommunication
Certifications:CPCUAIC
Tech Stack:CEP-MedicalCapstoneEnlyteODG

Company Brief

Nationwide
Nationwide is a mutual insurance and financial services company offering auto, home, life insurance, retirement planning, investments, and banking products for individuals and businesses across the United States.
Industry: Insurance
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Headquarters: Columbus, United States
Founded: 1926
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