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Senior RN: Clinical Claim Review Integrity & Compliance

Job in Spearfish, Lawrence County, South Dakota, 57783, USA
Listing for: CVS Health
Full Time position
Listed on 2026-10-30
Job specializations:
  • Nursing
    RN Nurse, Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 36000 - 77000 USD Yearly USD 36000.00 77000.00 YEAR
Job Description & How to Apply Below
Position: Senior RN: Clinical Claim Review for Integrity & Compliance

CVS Health is seeking a Clinical Claim Review Nurse to evaluate post-service medical claims by interpreting clinical data and applying established criteria, in line with regulatory requirements and plan benefits. The role requires independence in coordinating resolutions with clinicians and the ability to support claims processing teams.

You will review documentation from medical records, ensure confidentiality, and stay up to date with state and federal regulations.

Consider building your career as a Senior RN:
Clinical Claim Review for Integrity & Compliance at CVS Health.

For the Senior RN:
Clinical Claim Review for Integrity & Compliance position at CVS Health, we are reviewing applications now.

Step into the Senior RN:
Clinical Claim Review for Integrity & Compliance role at CVS Health in SD, United States and grow with us.

Please review the full job details above before applying.

Position Requirements
10+ Years work experience
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