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Healthcare Nursing

Remote RN: Medical Reviewer II – Claims & Utilization

Remote / Online - Candidates ideally in
East Providence, Providence County, Rhode Island, 02914, USA
Listing for: CGS Administrators LLC
Remote/Work from Home position
Listed on 2026-03-03
Job specializations:
  • Nursing
    Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below
A subsidiary of a major insurance company in Rhode Island is seeking a Registered Nurse to perform medical claims reviews and provide guidance on coverage determinations. Candidates must hold an active RN license and possess two years of clinical nursing experience. Responsibilities include educating staff, monitoring claims for accuracy, and participating in quality control activities. Join us for a fulfilling career that contributes to patient health and compliance with medical standards.
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