Sentara Health Plans is hiring a Clinical Claims Reviewer/RN. The role focuses on utilization management, pre/post payment claim reviews, and authorization assessments for various care settings.
Remote work options are available, with a background in acute care nursing and coding required. The successful candidate will ensure compliance with state and federal guidelines, including CMS and NCQA, and will handle post-payment inquiries and potential reconsiderations.
#J-18808-LjbffrRemote RN - Claims Reviewer & Utilization Review in workfromhome at Unknown Company
- Typical pay
- $85,280–$135,200
For context, most registered nurses earn between $85,280–$135,200 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and able to be worked remotely.