Remote RN: Clinical Claims Reviewer & Coding Expert

Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for a remote role. You will perform utilization management, comprehensive pre/post-payment claim reviews, and authorization assessments across inpatient, outpatient, and retrospective cases. The role requires an RN with a BSN and an active license, plus at least 3 years of acute care experience and Medical Coding certification within 12 months of hire. Remote opportunities and competitive benefits are offered.