Remote RN Claims Reviewer — Utilization & Denials Expert
Philadelphia, Philadelphia County, Pennsylvania, 19117, USA
Listed on 2026-10-20
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Nursing
RN Nurse
Sentara Health Plans is hiring a Clinical Claims Reviewer/RN for a remote role, with a 40-hour workweek and EST hours. The position requires RN licensure (compact or VA), a BSN, and at least 3 years of acute care experience, with CPC preferred. Remote opportunities span many states including PA.
Responsibilities include utilization management, detailed claim reviews, coding accuracy, and regulatory compliance with NCQA, CMS, DMAS, and BOI standards. Competitive benefits provided.
This is a great opportunity to take on the Remote RN Claims Reviewer — Utilization & Denials Expert role at Sentara Health.
Take a moment to read everything above and see whether this role is right for you.
This posting is for the Remote RN Claims Reviewer — Utilization & Denials Expert role at Sentara Health, based in PA, United States.
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