Remote RN: Inpatient Claims Review Specialist

University of Minnesota School of Nursing; Plymouth (MN); Remote; USD 60,000 - 108,000; Full time

Benefits offered by this job

Paid Time Off

Medical Plan options

Dental, Vision, Life & AD&D Insurance

401(k) Savings Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Employee Referral Bonus Program

Voluntary Benefits

Job summary

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support member care and cost management.

The role offers autonomy with accountability in a fast-paced production environment, requiring office setup at home and strong MS Office and writing skills. Telecommuting from anywhere in the U.S. is supported.

Qualifications

• Associate's degree required.
• Current and unrestricted RN license in the state of residency.
• 5+ years of clinical documentation experience.
• 3+ years of RN experience in inpatient/acute settings.
• Intermediate proficiency in Microsoft Office (Excel and OneNote).
• Strong writing skills and ability to work from a home office with reliable high-speed internet.

Responsibilities

• Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements.
• Responsible for documentation of all determinations.
• Maintain accurate use of screening criteria.

Skills

RN license

Clinical documentation

MS Office

Writing

Home office setup

Education

Associate's degree

Undergraduate degree preferred

Tools

Microsoft Excel

OneNote

Job description

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support member care and cost management.

The role offers autonomy with accountability in a fast-paced production environment, requiring office setup at home and strong MS Office and writing skills. Telecommuting from anywhere in the U.S. is supported.