Sentara Health Plans is seeking an experienced RN Clinician for a remote role to perform comprehensive claim reviews, pre- and post-payment, and authorization reviews across inpatient and outpatient settings.
You will handle provider inquiries and ensure adherence to policy and regulatory standards while supporting accreditation efforts.
The position requires an RN with a BSN, 3 years of acute care experience, and a CPC certification within 1 year. #J-18808-Ljbffr