Remote RN – Medical Claims Reviewer

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team, conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines.

Requirements

• Active, unrestricted RN license in the U.S. and in the state of hire
• Associate Degree in Nursing
• Two years of clinical experience
• Strong clinical background in managed care and/or inpatient/outpatient settings
• Ability to interpret and apply medical review criteria and clinical guidelines
• Proficiency in Microsoft Office and word processing software

Benefits

• Generous Paid Time Off
• 401k Matching
• Health insurance
• Dental insurance
• Vision insurance