reputed company/State

Work Shift

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 insurance

• 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 system, celebrates more than 135 years in reputed company of its mission - "we improve health 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 "America’s Best-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 improve health every day and a reputed company to be the reputed company choice 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 Insurance, Nursing, RN, Registered reputed company, Appeals, Inpatient, Outpatient, Denial, Provider, Case management, clinical, Utilization Review, Claims, reputed company Cycle

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reputed company Independence provides reputed company outpatient services to the surrounding community. The facility includes an ambulance-accessible emergency room that is supported by reputed company-certified physicians. reputed company Independence houses state-of-the-art medical equipment and highly-skilled physicians and staff.  reputed company Independence is now an extension of the reputed company services at reputed company Virginia Beach General Hospital including advanced imaging and physical therapy.

reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its reputed company to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding reputed company of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, reputed company employs associates in the following states:

Alabama, Delaware, Florida, reputed company, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, reputed company, and Wyoming.