Utilization Review Nurse

Utilization Review Nurse – Berkshire Hathaway GUARD Insurance Companies

Position to join our award‑winning team focused on providing top‑tier property and casualty insurance services nationwide.

Company Overview

Berkshire Hathaway GUARD Insurance Companies, owned by Warren Buffett’s Berkshire Hathaway group, is rated A+ “Superior” by AM Best. Headquartered in Wilkes‑Barre, PA, we employ over 1,000 people and have offices across the U.S. Our vision is to be a leading small‑business insurance provider. We foster a culture of accountability, service, integrity, empowerment, and diversity.

• Competitive compensation
• Healthcare benefits that begin on the first day of employment
• 401(k) retirement plan with company match
• Generous paid time off, including 9½ paid holidays
• Up to 6 weeks of parental and bonding leave
• Hybrid work schedule (3 days in office, 2 days remote)
• Longevity awards and tuition reimbursement after 6 months
• Continued training and career advancement opportunities

• Support internal claims adjusting staff in review of workers’ compensation claims.
• Review records and requests for UR received via mail, e‑mail, fax, or phone.
• Meet required decision‑making time frames.
• Document all communication and decision‑making within the insurance software system.
• Collaborate with clients, patients, employers, providers, and attorneys.
• Utilize clinical judgment, listening, and critical thinking skills.
• Track status of UR activity to meet turnaround times.
• Maintain organized files containing clinical documentation of all interactions.
• Generate appropriate letters upon completion of UR.

• Active Licensed Practical Nurse and/or Registered Nurse license.
• At least 1 year of utilization review experience at a managed care plan or provider organization.
• Minimum 2 years of clinical experience in case management, rehabilitation, orthopedics, or utilization review.
• Excellent oral, written, and phone communication skills.
• Strong interpersonal, conflict resolution, and teamwork skills.
• Ability to prioritize and work autonomously as well as part of a team.
• Well‑developed time‑management, organization, and analytical skills.
• Working knowledge of Microsoft Word, Excel, and Outlook.

• Seniority level:
  Entry level
• Employment type:
  
  Full‑time
• Job function:
  Health Care Provider
• Industry: Insurance

We are an equal opportunity employer committed to creating inclusive and welcoming work environment for all employees.

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