- Remote, United States
- Remote
- Full-time · Mid
- $29–$62 per hour
- 2+ years
As a Clinical Claim Review Nurse, you will leverage your clinical expertise to review medical records and post-service claims, apply established clinical criteria and policies, and support accurate claim determinations.
Compensation
The typical pay range for this role is: $29.10 - $62.32
Responsibilities
- Review and interpret clinical documentation from medical records and other systems
- Apply clinical judgment, criteria, and policies to evaluate post-service claims
- Coordinate clinical resolutions independently, consulting with clinicians or physicians as needed
- Serve as a clinical resource to customer service and claims processing teams
- Support the training and cross-training of team members
Requirements
- Associate's degree in Nursing
- Bachelor's degree in Nursing (RN)