Integrated Nurse Case Manager, Registered Nurse – Inpatient and Outpatient Clinical Appeals

ManagerManagerFull TimeRemoteSeniorTeam 10,001+Since 1890H1B No SponsorCompany SiteLinkedIn

Location

Virginia

Posted

21 hours ago

Salary

0

Seniority

Senior

Associate Degree3 yrs expEnglish

Job Description

Integrated Nurse Case Manager, Registered Nurse – Inpatient and Outpatient Clinical Appeals

Sentara Health

• 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

Job Requirements

  • 3 years experience in Nursing REQUIRED
  • RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred
  • Experience/knowledge in Rev Cycle, Utilization Review (UR) and Case Management preferred
  • Provider appeals experience is a plus
  • Strong proficiency in Excel

Benefits

  • Medical, Dental, Vision plans
  • Adoption, Fertility and Surrogacy Reimbursement up to $10,000
  • Paid Time Off and Sick Leave
  • Paid Parental & Family Caregiver Leave
  • Emergency Backup Care
  • Long-Term, Short-Term Disability, and Critical Illness plans
  • Life Insurance
  • 401k/403B with Employer Match
  • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
  • Student Debt Pay Down – $10,000
  • Reimbursement for certifications and free access to complete CEUs and professional development
  • Pet Insurance
  • Legal Resources Plan
  • Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

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