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State Licensed Medical Claim Nurse image - Rise Careers
Job details

State Licensed Medical Claim Nurse

Job Summary

A company is looking for a Medical Claim Review Nurse (RN).

Key Responsibilities
  • Perform clinical reviews of medical claims to ensure medical necessity and accurate billing
  • Identify and report quality of care issues and assist with complex claim reviews
  • Document clinical review findings and provide training and support to clinical peers
Required Qualifications, Training, and Education
  • Graduate from an Accredited School of Nursing
  • Minimum 3 years of clinical nursing experience
  • Minimum 1 year of Utilization Review and/or Medical Claims Review experience
  • Active, unrestricted State Registered Nursing (RN) license in good standing
  • Bachelor's Degree in Nursing or Health Related Field preferred

Average salary estimate

$70000 / YEARLY (est.)
min
max
$60000K
$80000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

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MATCH
VIEW MATCH
FUNDING
DEPARTMENTS
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
No info
EMPLOYMENT TYPE
Full-time, remote
DATE POSTED
July 4, 2025

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