Remote RN: Clinical Denials & Appeals Expert
Inova Health System
- Remote job
Inova Health System is seeking a Registered Nurse (RN) for Clinical Denials and Appeals. This full-time remote role supports denials and appeals across facilities, with start times between 7:30 AM–9:00 AM ET. The role requires a bachelor’s or associate degree with RN license and at least three years of RN experience in a clinical setting, plus Virginia RN licensure. Inova emphasizes strong teamwork, education, and patient-focused outcomes. #J-18808-Ljbffr Inova Health System
- Inova Health System is seeking a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team as a Full-Time Remote role. The position supports review of denied claims, development and submission of timely appeals, and collaboration across UR, Coding, Billing...Remote jobFull time
- ...Inova 8095 - Fairfax East Registered Nurse (RN) Clinical Denials and Appeals Inova 8095 - Fairfax East is looking for a dedicated Registered Nurse... ...Appeals to join the team. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start Time to be between...Remote workFull timeMonday to FridayFlexible hours
- ...Southwestern Medical Center in Dallas, TX invites applications for a Clinical Denial Management Specialist III in the Revenue Cycle Department.... ...complex surgical E/M denials, coordinate with payers, and submit timely appeals. #J-18808-Ljbffr UT Southwestern Medical CenterRemote jobWork from homeMonday to FridayShift work
- WPS Health Solutions is seeking an Appeals Nurse to review medical records and appeals for... ...services. This role involves evaluating clinical necessity, preparing compelling rationales... ...ideal candidate holds an ASN/BSN, an active RN license, and 1+ year of clinical...Remote job
- WPS Health Solutions is hiring an Appeals Nurse to review medical records and claims for first-level Medicare appeal... ...medically reviewed. Qualifications include an active RN license (state of practice), 1+ years clinical experience, and strong communication skills. #J-1880...Remote job
- UT Southwestern Medical Center seeks a Clinical Denial Management Specialist III to perform advanced medical billing/denial duties under supervision... ...and EPIC familiarity. CPC certification is a plus. 100% remote work with a shift Mon-Fri; benefits include comprehensive...Remote jobShift work
- ...Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area... ...Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA)... ...Registered Nursing Program; RN preferred. Minimum of five... ...in prior-authorization, appeals & grievance, or health plan...Remote workPermanent employmentTemporary work
- ...to do meaningful work, build a career, and feel proud serving your community—you belong at St. Joe’s. Job Summary The Clinical Denial Appeals Coordinator supports the Revenue Cycle by assessing and utilizing clinical and financial information to obtain optimal...Remote workWork at office
$92,289.6 - $120,577.6 per week
...40 Position Overview Responsible for clinical review, development, and submission of inpatient and outpatient clinical appeals for denied hospital claims. This role applies... ...appropriate reimbursement and reduce avoidable denials. MINIMUM REQUIREMENTS Education:...Full timeTemporary workPart timeWork at officeFlexible hours- UnitedHealth Group is seeking a Clinical Review Clinician in Plymouth, Minnesota. This role involves conducting forensic reviews of hospital... .... Candidates should have an Associate's degree, an active RN or LPN license, and at least 2 years of clinical experience. Benefits...Remote job
- WPS Health Solutions is seeking an Appeals Nurse (RN) to review first-level appeal cases and determine clinical necessity in accordance with Medicare guidelines. The role involves assessing medical records, preparing appeal letters, and ensuring timely resolutions with...Remote job
$100 - $150 per hour
...Management / Case Management leader (RN/Physician-advisor) Type:... ...00–$150/hour Location: Remote Role Responsibilities... ...necessity determinations and clinical review outputs for accuracy and... ...to-peer review requests, and denial appeals. Coordinate with clinical...Remote workContract workSummer workNight shift- Providence Home Services Oregon is seeking a Clinical Documentation Specialist RN to perform OASIS and Plan of Care reviews for CMS compliance, working remotely with day shifts and weekdays. The... ...Health leadership and acts as Oasis expert and consultant across the region....Remote jobDay shiftWeekday work
Clinical Documentation Specialist RN to ensure CMS program compliance through meticulous review of OASIS... ...and Plans of Care. This full-time, day shift role is remote for eligible states and collaborates with Home Health leadership...
Remote jobFull timeDay shift- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis of hospital facility bills. You will document, research, and identify adjustments as part of a team preparing Forensic Reviews for clients....Remote job
- ...rewarding role, you'll use your clinical knowledge outside of the... ...Registered Nurse (RN) license Strong clinical... ...vulnerable populations Remote work enjoy the convenience... ...generating authorization notices, denial letters, reason codes, and appeal rights in compliance with...Remote jobFull timeTemporary workWork at officeWork from home
$93 per hour
..., and Jack Dorsey . Position: Denials Management & Appeals Manager Type: Contract Compensation: $93/hour Location: Remote Role Responsibilities Lead denials... ...systemic root causes. Develop and manage clinical and technical appeal strategies across...Remote workContract workSummer work- CorroHealth, Inc. is seeking a part-time PRN Clinical Review Nurse (RN) to remotely review medical records for medical necessity, authorization compliance, and payer guideline alignment, supporting appeal submissions. You will perform clinical reviews, review inpatient...Remote jobPart timeRelief
- UnitedHealth Group is seeking an Utilization Management & Clinical Validation RN to accurately review medical records and extract case details, crafting defensible appeal letters using evidence-based literature and coding knowledge. You will work from anywhere in the U...Remote jobFlexible hours
- Providence Health and Services is seeking a Clinical Documentation Specialist, RN for the Oregon Home Services team. This role focuses on quality review... ...and Home Health leadership, acting as an Oasis expert and consultant to staff across the region, while upholding...Remote job
$150 per hour
...$150/hour Location: Remote Role Responsibilities... ...authorisation workflows for medical and clinical services across multiple... ...Track authorisation status, denials, and appeal outcomes to identify... ...Preferred Clinical licensure ( RN , LPN , or equivalent) or...Remote workContract workSummer workWork at office- ...Cottage Hospital is seeking a PRN Clinical Review Specialist to provide remote clinical review support. You will evaluate... .... The role requires an active RN license (compact preferred), 3-5... ...and 2+ years in Utilization Review/Appeals. Strong documentation and Epic EMR...Remote jobRelief
- Medica, a nonprofit health plan, is seeking a remote Appeals & Grievances Clinical Specialist III to review and resolve appeals and grievances with clinical... ...and clinical staff. This position requires an active RN license and 5+ years of clinical experience, preferably...Remote job
$71.59k - $116.48k
...prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case... .... The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job- Providence California Regional Services is seeking an Appeals RN in Case Management for a remote per diem position. This 8-hour day shift role focuses on managing clinically-based appeals and coordinating reimbursement conversations with external payers. The Care Management...Remote jobDaily paidDay shift
$70k - $80k
Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider... ...must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience. The...Remote jobFull timeContract workMonday to Friday$36 - $40 per hour
...our own path. We’re a remote-first staffing and consulting... ...industry. Our team of experts have placed thousands... ...career. If you are an Appeals and Denials Nurse looking for a... ...Our requirements: RN or FMG: CDIP, CCDS, CCS... ...95,000.00 1 month ago Clinical Review Nurse - Prior Authorization...Remote workPermanent employmentFull timeWork visa- Ready to Move Beyond Bedside Nursing? Join Our Clinical Appeals Team! ERISA Recovery is seeking an experienced Registered Nurse (RN) with a strong background in utilization management, clinical review, and denial appeals to join our growing team in Plano. This is an ideal...Relocation
- ...Recovery in Plano, TX is seeking an experienced Registered Nurse (RN) to move beyond bedside care into a strategic, analytical role focused on utilization management, clinical review, and denial appeals. You will analyze denied claims, perform medical necessity reviews...
- Managed Medical Review Organization, Inc. seeks an experienced RN Clinical Case Manager to support a disability claim review program. You... ..., owning caseload from start to finish. You will work remotely within allowed US states, performing telephonic assessments, developing...Remote job
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