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Remote Claims Review Nurse - Dispute Resolution Expert

Capitol Bridge.

Virginia, IL
  • Remote job

Capitol Bridge seeks an experienced Claims Review Nurse to resolve healthcare claim disputes under state IRO programs. You will evaluate documentation, coordinate with clinical reviewers, and work with health plans, providers, and enrollees to reach timely determinations with accuracy and professional integrity. This remote position supports state-wide health plan disputes, requires active nursing licensure and at least five years of patient care experience, and emphasizes compliance with CPT #J-18808-Ljbffr Capitol Bridge.

Vacancy posted 2 days ago
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