Remote Bill-Review Nurse: Managed Care Specialist
Summit Consulting
- Remote job
SCI Summit Consulting, LLC in Lakeland, FL seeks a Registered Nurse with 14+ years in case management or managed care to oversee medical reviews, negotiate pre-surgical services, and drive cost containment. You will provide expert guidance to Claims staff and may coach teammates. Excellent collaboration and discretion are essential. The role supports a hybrid schedule with four on-site days and one remote day, with potential full remote consideration based on availability. #J-18808-Ljbffr Summit Consulting
- ...Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply... ..., and 3+ years in a clinical setting plus 1 year in managed care or utilization management. This is a 7-month contract with...Remote jobContract work
- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've... ...containment. Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...Remote workImmediate start
$76.95k - $108.87k
...when you need a specialist who not only... ...Responsibilities Reviews Facility and Professional bills as it compares... ...performance management for direct reports... ...work one day remotely. Core in-office... ...Healthcare Management, Nursing, or a related... ...or managed care experience....Remote workFull timePart timeWork at office- ...Job TitleRegistered Nurse (RN) for Critical Incident Management TeamLocationHarrisburg, Pennsylvania... ...traditional bedside care and take on a position... ...will be responsible for reviewing and evaluating critical incidents... ...technology to support remote and hybrid work functions...Remote workWork from home
- ...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely discharges, and refer members to appropriate resources while working remotely. Key responsibilities Assist in building and implementing...Remote workFull time
- ...families, support foster care and adoption, and... .../Receivable Specialist, you’ll help carry... ...to the agency; Manage accounts payables... ...foster child; Review monthly R&E reports... ...related position; Billing/invoicing... ...¯lifeâ¯insurance #LI-CC1 #LI-Remote...Remote workFull timeLive outWork at officeLocal area
- ...AvonRisk Medical Bill Reviewer AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals...Remote work
- ...Working remotely, the full-time Medical Billing Specialist will manage the entire billing cycle, including accurate code assignment, claim submission, payment posting... ...and timely reimbursement. Key responsibilities Review clinical documentation and assign accurate...Remote workFull timePrivate practice
- ...Shift: Day Position summary: Immediately hiring Long Term Care Managed Care Billing Specialist to join an established team of exceptional and... ...being served. Job Responsibilities & Duties Preparing, reviewing and transmitting electronic claims using our billing software...Work at officeImmediate startShift work
- ...Claims Review Management Nurse (RN) We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid... ...based in Harrisburg, PA, with a hybrid schedule (three days remote, two days onsite). This position plays a critical role in overseeing...Remote workLong term contractFull timeContract workWork at office2 days per week
- OCHIN, Inc. is seeking a Billing Specialist to provide accurate revenue cycle and account management services to OBS member clinics, primarily supporting Acute Care. You will work remotely, with attention to detail and strong communication to ensure timely, compliant billing...Remote job
$85 per hour
...Position: Underpayment & Managed-care Contract Specialist Type: Contract Compensation... ...$85/hour Location: Remote Role Responsibilities... ..., per diem, percent-of-billed charges, and fee schedule... ....com PS: Our team reviews applications daily. Please...Remote workDaily paidContract workSummer work- ...Medical Billing Specialist (Revenue Cycle Management) This is not a remote position; it is in the office Monday - Friday. This is not an entry-level role and requires... ...up on Accounts Receivable exceeding 30 days Review AR aging reports and resolve outstanding balances...Remote workTemporary workWork at officeMonday to Friday
- Orthos, Inc. is seeking a remote Billing Specialist to support patient inquiries, review and submit insurance claims, and manage accounts receivable for orthopedic services. The ideal candidate has 2+ years in medical billing with strong denials management and payer knowledge...Remote job
- Wheaton Eye Clinic seeks a Medical Billing and Insurance Representative for a full-time... ...Responsibilities include handling medical claims, reviewing eligibility, and ensuring billings meet... ...Encoder Pro are a plus. This is a non-remote position with competitive pay. #J-18808...Remote workFull time
- Washington University offers a Certified Coder (Remote) position focusing on Orthopedic Surgery. You will review medical records to assign CPT and ICD-10 codes, meet... ...to review documentation, and assist with billing workflows. The role emphasizes accurate coding and...Remote job
$17 - $20 per hour
...Remote Patient Care Specialist Pacific Medical Data Solutions, a company of LifePoint... ...nationwide revenue cycle management services provider that has... ...high quality medical billing services since 2004. Headquartered... ...) Conducts chart reviews and ensure all diagnostic...Remote workWork at officeLocal area- ...Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior... ...* Admission Criteria Care coordination Concurrent... ...Terminology) coding and billing Medical Necessity Utilize... ...Additional Skills remote UR work CA and Medi-Cal...Remote work
- ...and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions,... ...stakeholders to negotiate appropriate care levels Maintain client... ...Bachelor's degree in nursing (BSN) from an accredited institution...Remote workFull timeWork experience placement
- ...Refer a Friend Back Remote Work from Home Share This... ..., MD 21076 Category: Nursing Schedule: Day Shift Employment... ...Health Plans (JHHP) is the managed care and health services business... ...:00 PM As a Utilization Review Registered Nurse for Johns...Remote workFull timeLocal areaWork from homeMonday to FridayDay shift
- US Oncology Inc. is seeking a Full Time Billing Specialist to manage payer and patient account balances, monitor delinquent accounts, and perform collection activities in a remote work setting. You will review payment postings, resolve billing issues, verify demographics...Remote jobHourly payFull time
- ...Nurse Paralegal The Nurse Paralegal supports... ...attorneys by reviewing and organizing medical... ...requests, and manages communication with... ...time in time and billing system Organize... ...summaries of medical care Update... ...be designated as remote, hybrid, or fully...Remote workWork at office
$59k - $62k
...Care Specialist Pelago is the leading specialty substance use care provider... ...than 750,000 members better manage their substance use. If you'... .... This is a direct-service, remote clinical role based anywhere... ...and fair pay philosophy and review total compensation for our employees...Remote workFull timeTemporary workHome officeFlexible hours$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson... ...no holidays, no telehealth/remote work Minimum... ...experience in direct patient care • 12 consecutive months in... ...Utilization Management, Utilization Review, or Case Management ~•...Remote workContract workImmediate startMonday to Friday- ...behalf of a partner company, who manages all applications and next... ...for a Lead PFS Medical Billing Specialist based in United States. This... ...needed and provide quality reviews, workflow oversight, and mentoring... ...week. Benefits: Fully remote work for candidates residing...Remote workFull timeMonday to Friday
- ...Transcarent is hiring a Remote Care Operations Specialist to support day-to-day execution of care programs. You will analyze cases, review cost shares, and support savings workflows while... ...communication skills to work with clinical, billing, and client teams in a fast-paced...Remote work
$61.05k - $98.33k
...Itemization Review Nurse The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on... ...submitted by a medical facility to determine accuracy of billed charges. This is a remote position. Essential Functions & Responsibilities:...Remote workFull timeWork at officeFlexible hours$40 per hour
...Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance... ...for performing initial, concurrent review activities; discharge care coordination...Remote workFull timeContract workWork at office$31.25 - $32.94 per hour
...where we work. This is a remote role that may be performed from... ...role is on the menu The Billing Operations Associate owns the... ...Commercial contracts are reviewed to identify billing requirements... ...to detail with the ability to manage high-volume workloads...Remote workPermanent employmentContract workWork at officeWork from homeFlexible hours$44.88 per hour
...Hour Job Category Nursing Employee Type Non-Exempt... ...2 Year Degree Manage Others No Summary:... ...excellent nursing care to patients in the... ...with Washington State Bill 5123 for this safety... ...new hires, including remote or hybrid schedules... ...Annual performance review bonus License...Remote workFull timeWork at officeShift workWeekend work
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