Medical Claims Reviewer Jobs – (At Remote RN)

CVS Health is hiring experienced Registered Nurses (RNs) for fully remote Medical Claims Reviewer positions. This non-clinical RN role focuses on evaluating and processing medical claims, ensuring compliance with healthcare standards.

Job Overview:
- Job Title: Medical Claims Reviewer (Remote RN)
- Company: CVS Health
- Location: Remote (United States only)
- Employment Type: Full-Time
- Salary Range: $75,000 – $95,000 per year

Responsibilities:
- Review medical claims for clinical accuracy
- Validate coding and coverage eligibility
- Communicate with providers
- Ensure compliance with HIPAA and CMS

Qualifications:
- Active U.S. RN license
- 3+ years clinical experience
- Background in claims review/utilization review
- Knowledge of CPT/ICD-10 coding
- Detail-oriented and analytical

Benefits:
- Remote flexibility
- Full healthcare coverage
- PTO and 401(k)
- Advancement opportunities

How to Apply:
Submit your resume and RN license online. Qualified applicants will be invited for virtual interviews.