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Rn Claims Jobs (NOW HIRING)

Critical Nurse Staffing

Registered Nurse (RN)

Ammon, ID · On-site

$55 - $60/hr

Registered Nurse - RN Part Time Available: Arco: 4 hours per week $55.00 - $60.00 per hour DOE and ... Armed Services, Workers Compensation Claims, and former energy workers who want to remain ...

Critical Nurse Staffing

Registered Nurse (RN)

Spokane, WA · On-site

$55 - $65/hr

Registered Nurse - RN Part Time - 3 to 6 hours a week. $55.00 - $65.00 per hour Come work for a ... Claims, and former energy workers who want to remain independent and live in their own homes. We ...

Critical Nurse Staffing

Registered Nurse (RN)

Casper, WY · On-site

$50/hr

Registered Nurse - RN $50.00 per hour -DOE - Private duty caregiver Full and Part Time Shift ... Claims, and former energy workers who want to remain independent and live in their own homes. Here ...

Critical Nurse Staffing

Registered Nurse (RN)

Denver, CO · On-site

$45 - $55/hr

Registered Nurse - RN Part Time Available 12 hours per week and cover PTO, Call offs, and New ... Claims, and former energy workers who want to remain independent and live in their own homes. Here ...

Critical Nurse Staffing

Registered Nurse (RN)

Conifer, CO · On-site

$45 - $55/hr

Registered Nurse - RN Part Time: Conifer: 14 hours per month ***$1500 SIGN ON BONUS*** $45.00 - $55 ... Claims, and former energy workers who want to remain independent and live in their own homes. Here ...

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All JobsFinance And Insurance JobsInsurance JobsInsurance Claims Specialist JobsRN Claims Jobs

Rn Claims information

See salary details

$35K

$87.9K

$139K

How much do rn claims jobs pay per year?

As of Sep 13, 2026, the average yearly pay for rn claims in the United States is $87,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $105,000.00 per year, depending on experience, location, and employer.

What is the difference between Rn Claims vs Medical Claims Specialist?

AspectRn ClaimsMedical Claims Specialist
Required CredentialsRN license, healthcare knowledgeMedical billing certification, insurance knowledge
Work EnvironmentHospitals, clinics, healthcare facilitiesInsurance companies, billing offices
Employer & Industry UsageHealthcare providers, hospitalsInsurance carriers, third-party administrators
Common Search & ComparisonYesNo

Rn Claims primarily involves processing insurance claims related to nursing and healthcare services, often requiring a nursing license. Medical Claims Specialist focuses on billing and claims processing within insurance companies, requiring billing certifications. While both roles handle healthcare claims, Rn Claims emphasizes clinical knowledge, whereas Medical Claims Specialists focus on billing procedures.

What states have the most Rn Claims jobs?

States with the most job openings for Rn Claims jobs include:

What are popular job titles related to Rn Claims jobs?

For Rn Claims jobs, the most frequently searched job titles are:

Rn Claims jobs near you

Claims - Care Manager, RN, Claims

Pensacola, FL • On-site

Wellcove
See more jobs at Wellcoveexternal

Full-time

Re-posted 15 days ago

Job description

Who We Are
Wellcove has been recognized as the nation's leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don't stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.
Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.
We are seeking an experienced Registered Nurse (RN) to serve as a Care Manager supporting Long Term Care (LTC) insurance claims. This individual contributor role is responsible for conducting comprehensive clinical eligibility reviews to determine whether policyholders meet the benefit eligibility requirements outlined in their LTC policy.
The Care Manager, RN will complete and document Chronically Ill Certifications (CICs) and develop Plans of Care (POCs) for initial claims and ongoing recertifications, ensuring determinations are clinically sound, and policy aligned.
Key Responsibilities
  • Perform detailed clinical reviews of LTC claim files to determine eligibility in accordance with policy provisions and regulatory requirements.
  • Assess Activities of Daily Living (ADLs), cognitive impairment, diagnoses, comorbidities, and level of care needs.
  • Review medical records, Minimum Data Set (MDS) assessments, facility documentation, home health records, daily visit notes, and supporting claim forms.
  • Determine whether the insured meets the policy definition of Chronically Ill.
  • Prepare and document Chronically Ill Certifications (CICs) and individualized Plans of Care (POCs) for initial approvals and recertifications.
  • Clearly document clinical rationale to support benefit determinations.
  • Collaborate with Claims, Eligibility, and Customer Service teams to obtain additional documentation when necessary.
  • Maintain knowledge of LTC policy language, benefit triggers, and regulatory requirements.

Qualifications
  • Active, unrestricted Registered Nurse (RN) license required.
  • Clinical experience in long-term care, home health, geriatrics, case management, or utilization review preferred.
  • Experience reviewing medical records and assessing functional and cognitive impairment.
  • Knowledge of LTC insurance benefit triggers, ADL requirements, and chronically ill certification standards preferred.
  • Strong clinical judgment, critical thinking, and documentation skills.
  • Ability to manage multiple cases and meet turnaround expectations.

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

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