IRR Clinical Claim Review RN

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IRR Clinical Claim Review RN

Plymouth, Massachusetts

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Caring. Connecting. Growing together. With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve.

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IRR Clinical Claim Review RN

Requisition number: 2373277

Job category: Nursing

Primary location: Plymouth, Massachusetts

Date posted: 07/24/2026

Overtime status: Non-exempt

Travel: No

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Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start  Caring. Connecting. Growing together. The  IRR Clinical Claim Review Nurse  performs claim reviews to verify correct coding and correct charges. The clinical reviewer is responsible for documenting, researching state and federal guidelines and following internal procedures to determine the viability of the claim for further review in a production environment.  Employees in this position receive limited supervision within a broad framework of policies and procedures and possess a comprehensive understanding of the claim review process including clinical claim review, medical record review, and a broad knowledge of applicable processes, procedures and billing guidelines. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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