Integrated Nurse Case Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia!

Job description

City/State Virginia Beach, VA Work Shift: First (Days) Overview: Sentara Health Plans is hiring an Integrated Nurse Case Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Overview: Manage inpatient and outpatient provider appeals across all payer types, including government and commercial insurance Review clinical denials (non-billing related), identify root causes, and perform post-claim analysis to support appeal submissions Education: N-3YR - RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred Certification/Licensure: Registered Nurse (RN) License (Compact or Virginia) preferred Experience: 3 years experience in Nursing REQUIRED Experience/knowledge in Rev Cycle, Utilization Review (UR) and Case Management preferred Provider appeals experience is a plus Strong proficiency in Excel: Sentara Health , an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission - "we improve health every day." Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Sout...