RN Claims Review Specialist — Clinical Insight & Resolution
Listed on 2026-10-30
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Nursing
CVS Health in Maryland is seeking a Clinical Claim Review Nurse to evaluate and adjudicate post-service medical claims using clinical criteria and policies. You will review documentation, interpret data from records, coordinate resolutions with clinicians, and support claims processing teams while ensuring compliance with state and federal laws.
The role requires RN with 2–3 years of professional experience, an associates degree in nursing (BSN preferred), and strong analytical skills.
The RN Claims Review Specialist — Clinical Insight & Resolution position in the Bio & Pharmacology & Health field is open for applications.
This opportunity is part of our work in Bio & Pharmacology & Health.
The advertised compensation is 36.000 - 77.000.
We aim to respond to suitable candidates as soon as possible.
Full responsibilities and requirements are described in the listing above.
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