Texas Licensed Claims Review RN

This job has been removed

Location: Remote

Compensation: To Be Discussed

Reviewed: Fri, Apr 03, 2026

This job expires in: 6 days

Job Category: Healthcare

Weekly Hours: Full Time, Part Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A company is looking for a Claims Review RN.

Key Responsibilities

Audit claims for coding and utilization accuracy, providing clinical feedback as needed
Optimize utilization by identifying services and resources for effective client care
Review and research member/provider appeals, ensuring compliance with regulations and corporate standards

Required Qualifications

5+ years of related nursing work experience
Related Bachelor's degree or equivalent work experience
Graduate of an accredited school of nursing
RN - Registered Nurse - State Licensure
Previous claims review/coding experience

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