Integrated Nurse Case Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- R (Hiring Immediately)

Virginia Beach, VA

First (Days)

• Manage inpatient and outpatient provider appeals across all payer types, including government and commercial insurance
  
• Review clinical denials (non-billing related), identify root causes, and perform post-claim analysis to support appeal submissions
  

• N-3YR - RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred
  

• Registered Nurse (RN) License (Compact or Virginia) preferred
  

• 3 years experience in Nursing REQUIRED
  
• Experience/knowledge in Rev Cycle, Utilization Review (UR) and Case Management preferred
  
• Provider appeals experience is a plus
  
• Strong proficiency in Excel
  

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Talroo - Nursing

Managed Care, MCO, Health Plan, Healthcare, Health Insurance, Nursing, RN, Registered Nurse, Appeals, Inpatient, Outpatient, Denial, Provider, Case management, clinical, Utilization Review, Claims, Revenue Cycle

• Adoption, Fertility and Surrogacy Reimbursement up to $10,000

• Paid Time Off and Sick Leave

• Paid Parental & Family Caregiver Leave

• Emergency Backup Care

• Long-Term, Short-Term Disability, and Critical Illness plans

• Life Insurance

• 401k/403B with Employer Match

• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education

• Student Debt Pay Down - $10,000

• Reimbursement for certifications and free access to complete CEUs and professional development

• Pet Insurance

• Legal Resources Plan

• Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

In support of our mission to improve health every day, this is a tobacco-free environment.

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.