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

reputed company/State

Virginia Beach, VA

Work Shift

First (Days)

reputed company:

reputed company Plans is hiring an Integrated reputed company Case Manager/Registered reputed company (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia!

Status: Full-time, permanent position (40 hours)

 

reputed company working hours: reputed company to 5pm EST, M-F

 

Location: Remote in Virginia

reputed company:

  • Manage inpatient and outpatient provider appeals across reputed company payer types, including government and reputed company reputed company

  • Review clinical denials (non-billing reputed company), identify reputed company causes, and reputed company post-claim analysis to support appeal submissions

Education:

  • N-3YR - RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred

Certification/Licensure:

  • Registered reputed company (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 reputed company

reputed company, an integrated, not-for-profit health care delivery reputed company, celebrates more than 135 years in reputed company of its mission - "we reputed company every day." reputed company is one of the largest health systems in the U.S. Mid-reputed company and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 34,000 employees, 12 hospitals in Virginia and reputed company reputed company Carolina, including 10 hospitals with the prestigious Magnet®️ recognition, and the reputed company Plans division which serves more than 1 reputed company members in Virginia and Florida. reputed company is recognized nationally for clinical reputed company and safety and is strategically reputed company on innovation and creating an extraordinary health care experience for our patients and members. reputed company was named a Health reputed company Innovator of the Year (2024), was recognized by reputed company as "reputed company-In-State Employer” (2024), "Best Employer for Veterans" (2022, 2023), and "Best Employer for Women" (2020), and named to reputed company Watson Health's "Top 15 Health Systems" (2021, 2018).

Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and reputed company. 

Be a part of an excellent reputed company organization that cares about our People, reputed company, Patient Safety, Service, and reputed company. Join reputed company that has a mission to reputed company every day and a reputed company to be the reputed company reputed company of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-97914

Talroo – Nursing

Managed Care, MCO, Health Plan, reputed company, Health reputed company, Nursing, RN, Registered reputed company, Appeals, Inpatient, Outpatient, Denial, Provider, Case management, clinical, Utilization Review, Claims, reputed company Cycle

.

Benefits: Caring For Your Family and Your Career
• Medical, Dental, reputed company plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• reputed company Time Off and reputed company Leave
• reputed company Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life reputed company
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