Cost Review/Utilization Nurse

Why Join GEICO?

At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.

Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive on relentless innovation to exceed our customers' expectations while making a real impact on local communities nationwide.

Founded in 1936, GEICO is a member of the Berkshire Hathaway family of companies and one of the largest auto insurers in the United States. When you join our company, we want you to feel valued, supported, and proud to work here. That's why we offer the GEICO Pledge: Great Company, Great Culture, Great Rewards, and Great Careers.

Put Your Clinical Experience to Work in a Different Way

If you're a licensed nurse who enjoys analyzing medical information, solving complex problems, and applying clinical expertise beyond direct patient care, the Cost Review/Utilization Nurse role provides an opportunity to make an impact.

You'll review medical information and treatment, evaluate medical necessity and appropriateness of care, and partner with claims professionals and medical resources to provide informed recommendations. Your clinical expertise will help support sound decisions and positive outcomes for injured customers.

What You'll Do

• Review medical records, treatment plans, and related documentation to evaluate medical necessity and appropriateness of care.

• Apply established clinical guidelines when evaluating healthcare services and treatment.

• Analyze provider claims and medical documentation, including applicable ICD and CPT coding.

• Conduct Hospital Bill Reviews to evaluate the necessity and appropriateness of treatment.

• Partner with claims professionals to provide clinical insight and recommendations.

• Serve as a clinical resource to colleagues without a medical background.

• Consult with medical professionals when additional medical expertise is necessary.

• Coordinate external medical reviews when appropriate.

• Accurately document assessments, findings, and recommendations.

• Manage multiple reviews and priorities while maintaining accuracy, quality, and compliance.

What You'll Bring

• A current Registered Nurse (RN), Licensed Practical Nurse (LPN), or Advanced Practice Nurse (APN) license that is active, unencumbered, and in good standing.

• Multistate/compact nursing licensure.

• Strong clinical assessment, analytical, and critical-thinking skills.

• Knowledge of medical terminology, diagnoses, treatment, and healthcare documentation.

• Ability to interpret complex medical information and communicate recommendations clearly.

• Strong written and verbal communication skills.

• Ability to work effectively both independently and collaboratively.

• Strong organization and ability to manage multiple priorities.

Licensure & Certification

Multistate/compact nursing licensure is required for this position. Based on the requirements provided by the hiring team, additional individual state licenses are not required, and there are no additional required certifications such as CCM, CPUR, or URAC-related credentials.

Work Arrangement

This position requires full-time onsite work for the first six months. After the initial six-month period, the position will transition to a hybrid work arrangement, subject to business needs and applicable workplace requirements.

Why This Role

This is an opportunity to use your nursing background in a role focused on clinical analysis, medical decision support, and collaboration. Your expertise will directly support appropriate care decisions and positive outcomes for injured customers.

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The GEICO Pledge:

Great Company: Protecting customers through life’s twists and turns with innovation and integrity.

Great Careers: Personalized development programs, mentorship, and certification assistance.

Great Culture: Inclusive and collaborative culture rooted in shared success.

Great Rewards: Competitive pay, benefits, and flexibility to support your well-being and future.

The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled.

GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.