Verisk

Pflegekraft für medizinische Rechnungsprüfung (m/w/d)

Verisk  •  Köln, DE (Hybrid)  •  2 hours ago
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Job Description

In dieser Rolle arbeitest du an der Schnittstelle zwischen Medizin und Versicherungswelt und sorgst dafür, dass medizinische Leistungen korrekt, nachvollziehbar und fair abgerechnet werden. Dein Fachwissen hilft dabei, Transparenz zu schaffen und fundierte Entscheidungen zu ermöglichen – mit spürbarem Mehrwert für unsere Versicherungspartner.

Deine Aufgaben

  • Prüfung medizinischer Rechnungen im Rahmen von Regress- und Leistungsfällen
  • Bewertung und Anwendung gängiger Abrechnungssysteme (DRG, GOÄ, UV-GOÄ, EBM)
  • Identifikation von Falschabrechnungen sowie Durchführung von Plausibilitätsprüfungen
  • Klärung fachlicher Rückfragen mit Versicherungskunden – schriftlich und telefonisch

Must-have:

  • Abgeschlossene Ausbildung als Pflegefachkraft, Gesundheits- und Krankenpfleger:in, Physiotherapeut:in oder vergleichbar
  • Mindestens 2 Jahre relevante Berufserfahrung im medizinischen Umfeld
  • Sehr gute medizinische Fachkenntnisse und ein hohes Qualitätsbewusstsein
  • Deutschkenntnisse auf nahezu muttersprachlichem Niveau in Wort und Schrift
  • Strukturierte, sorgfältige und lösungsorientierte Arbeitsweise

Nice to have:

  • Erfahrung mit medizinischen Abrechnungssystemen (DRG, GOÄ, UV-GOÄ, EBM)
  • Erste Berührungspunkte mit Versicherungen, Leistungsprüfung oder Gutachten
  • Sicherer Umgang mit digitalen Systemen und Dokumentationen

Was wir bieten

  • Gleitzeit & flexible Arbeitszeitgestaltung – plane deinen Arbeitstag so, wie er zu deinem Leben passt.
  • Mobiles Arbeiten bis zu 50 % –arbeite flexibel im Büro und aus dem Homeoffice.
  • 30 Urlaubstage –für ausreichend Erholung, Ausgleich und neue Energie.
  • Umfassende medizinische Vorsorge –z. B. kostenlose Augenuntersuchungen, Impfangebote und weitere präventive Gesundheitschecks.
  • Deutschlandticket für nur 20 € Arbeitnehmeranteil – entspannt, nachhaltig und kostengünstig unterwegs.
  • Fahrrad-Leasing nach der Probezeit – bleib mobil und umweltbewusst, auch außerhalb der Arbeit.
  • Betriebliche Altersvorsorge – mit einem steigenden Arbeitgeberanteil, der mit deiner Betriebszugehörigkeit wächst.
  • Corporate Benefits – exklusive Mitarbeiterrabatte bei zahlreichen bekannten Marken, Online-Shops und Freizeitangeboten.

#LI-KS1 #Hybrid

Our People, Our Culture

For more than 50 years, Verisk has helped property and casualty insurers make smarter decisions about risk through AI-powered risk modeling, advanced analytics, and technology solutions spanning the entire policy lifecycle. We are a leading strategic data, analytics, and technology partner to the global insurance industry, guided by core values of learning, caring, and results while maintaining the highest ethical standards as stewards of the industry's most comprehensive datasets. Learn more about Verisk and what we are doing within the insurance industry.

For the eighth consecutive year, Verisk is proudly recognized as a Great Place to Work® for outstanding workplace culture in the US, the fourth consecutive year in the UK, Spain, and India, and the second consecutive year in Poland. In addition, we’ve been recognized by The Wall Street Journal as one of the Best-Managed Companies and by Forbes as a World’s Best Employer, testaments to the value we place on workplace culture.

Our Culture Explore our inclusive, people-first culture that fosters innovation, collaboration, and belonging.

Awards & Recognition See why Verisk is consistently recognized as a Great Place to Work™ around the world.

Our Businesses Learn about the diverse industries we serve — from insurance and energy to financial services and beyond.

Life at Verisk Discover what it’s like to work at Verisk through employee stories, team highlights, and culture moments.

Careers at Verisk Join a global team of problem-solvers and innovators doing meaningful work that’s shaping the future of industries. Whether you're just starting out or looking to take your career to the next level, Verisk offers growth, purpose, and a people-first culture

Let’s build something meaningful together!

Verisk Analytics is an equal opportunity employer.

All members of the Verisk Analytics family of companies are equal opportunity employers. We consider all qualified applicants for employment without regard to race, religion, color, national origin, citizenship, sex, gender identity and/or expression, sexual orientation, veteran's status, age or disability. Verisk’s minimum hiring age is 18 except in countries with a higher age limit subject to applicable law.

https://www.verisk.com/company/careers/

Unsolicited resumes sent to Verisk, including unsolicited resumes sent to a Verisk business mailing address, fax machine, or email address, or directly to Verisk employees, will be considered Verisk property. Verisk will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume.

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About Verisk

Verisk provides expert data-driven analytic insights to the global insurance industry that help businesses, people, and societies become stronger, more resilient, and sustainable.

Since we opened our doors in 1971, we’ve been driven by a passion for using data and insights to make a difference—helping protect people, economies, society, and our planet.

For more than 50 years, we’ve combined our unique data with advanced technologies in new ways to unlock meaningful insights about risk, moving forward to become a global leader in cutting-edge analytics. We’ve stayed at the forefront of developing insurance innovations to help clients manage the risks they face.

Globally, we’re more than 7,500 people strong, all of us on a mission to achieve both profitable outcomes and positive societal impact. Verisk has received U.S. certification from Great Place to Work® for seven consecutive years. Verisk has also earned Great Place to Work certifications in the United Kingdom, Spain, Poland and India. In addition, Verisk was named one of the Best Workplaces in New York by Fortune magazine and Great Place to Work. In the United Kingdom, Verisk was recognized by Great Place to Work as a Best Workplace for women, tech and well-being. Verisk was also honored on the Best Workplaces lists in the UK, Spain and Málaga.

To keep up on the latest Verisk news, follow us on X, Facebook, and YouTube.

Industry
Unknown
Company Size
5,001-10,000 employees
Headquarters
Jersey City, NJ
Year Founded
1971
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