Integrated Nurse Case Manager, Registered Nurse (RN) – Inpatient and Outpatient Clinical Appeals

Posted 2026-05-06
Remote, USA Full-time Immediate Start
    Job Description:
  • Manage inpatient and outpatient provider appeals across all payer types, including government and commercial insurance
  • Review clinical denials (non-billing related), identify root causes, and perform post-claim analysis to support appeal submissions
    Requirements:
  • 3 years experience in Nursing REQUIRED
  • RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred
  • Registered Nurse (RN) License (Compact or Virginia) preferred
  • Case Management experience preferred
    Benefits:
  • Medical, Dental, Vision plans
  • Adoption, Fertility and Surrogacy Reimbursement up to $10,000
  • Paid Time Off and Sick Leave
  • Paid Parental & Family Caregiver Leave
  • Emergency Backup Care
  • Long-Term, Short-Term Disability, and Critical Illness plans
  • Life Insurance
  • 401k/403B with Employer Match
  • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
  • Student Debt Pay Down – $10,000
  • Reimbursement for certifications and free access to complete CEUs and professional development
  • Pet Insurance
  • Legal Resources Plan
  • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

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