1 professional review nurse jobs found in Brea

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  Under technical direction, investigates and maintains Long Term Care claims. Works within specific limits of authority on assignments of significant technical complexity and coordination. Utilizing claims policies and guidelines, reviews coverages, determines liability and compensability, secures information, and negotiates and settles claims. JOB DESCRIPTION: Essential Duties & Responsibilities Performs a combination of duties in accordance with departmental guidelines: Interprets more complex or unusual policy coverages and determines if coverages apply to claims submitted, escalating issues as needed. Sets activities, reserves and authorizes payments within scope of...