Remote RN Claims Reviewer - Utilization & Post-Payment
Full-time
Sentara Health
We are hiring: Remote RN Claims Reviewer - Utilization & Post-Payment — Sentara Health — Remote. Type: Full-Time. This is an excellent opportunity for the right candidate. The full description, requirements, and application instructions are provided below. Posted: Oct 21, 2026. Sentara Health Plans is seeking a Clinical Claims Reviewer RN for a remote, full-time position (40 hours/week). The role centers on utilization management, including pre/post payment claim reviews and authorization oversight for inpatient and outpatient settings. The ideal candidate holds a BSN, has at least 3 years of acute care experience, and understands coding guidelines. NCQA and CMS knowledge is preferred; a Medical Coding certification must be obtained within 1 year of hire. #J-18808-Ljbffr
Vacancy posted 8 hours ago
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