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-LjbffrUtilization Review Nurse in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.