Remote RN Claims Reviewer: Utilization & Appeals

Sentara Health

Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate referrals to Medical Directors.

Requirements include a BSN, an RN license, and 3 years of acute care experience. The role supports multiple states and offers full-time employment with competitive pay and benefits.

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Vacancy posted 3 days ago

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