Remote RN: Clinical Claims Review (Short-Stay)
Stryker
Stryker Corporation is looking for a Clinical Claims Review RN to perform reviews of inpatient hospital claims. This role supports a high-volume environment and allows for telecommuting from anywhere in the U.S. The ideal candidate must have an RN license, a minimum of 5 years of clinical documentation experience, and an associate's degree. Additional benefits include paid time off, health insurance, and a 401(k) savings plan. #J-18808-Ljbffr
- Optum, part of the UnitedHealth Group, is looking for a Clinical Claims Review RN to conduct administrative reviews of short stay inpatient hospital claims. This position is open to telecommuting from anywhere in the U.S. and is situated in a high-volume, production-driven...Remote jobClaims
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Claims Review RN to perform administrative reviews of short-stay inpatient hospital claims. This role supports a production-driven environment and allows telecommuting from anywhere in the U.S. The ideal candidate must have an associate...Remote jobClaimsHourly pay- The University of Minnesota School of Nursing is looking for a Clinical Claims Review RN to conduct administrative reviews of short-stay inpatient hospital claims. This role enables telecommuting from anywhere in the U.S. and is part of a high-volume, production-driven...Remote jobClaims
$28.94 - $51.83 per hour
...Ssbv Clinical Claims Review Rn Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...Responsibilities: Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal,...Remote jobClaimsHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaHome office$28.94 - $51.83 per hour
Optum, part of the UnitedHealth Group, is seeking a Clinical Claims Review RN (SSBV) to perform administrative reviews of short‑stay inpatient hospital claims and document determinations. The role supports a high‑volume, production‑driven environment and is eligible for...Remote workClaimsHourly payFull timeTemporary workWork at officeHome office$36 - $48 per hour
...Santa Barbara Cottage Hospital is seeking a Medical Claims Clinical Review Nurse for a remote position. This role involves conducting clinical reviews of... ...compliance with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote workClaimsHourly pay$90k - $110k
...Description Description: Job Role The Clinical RN Chart Reviewer will perform clinical reviews of... ...documentation to validate issues of claims coding accuracy, medical necessity, and... ...benefits ~401K with company match ~ Short- and Long-Term Disability ~ Group...Remote jobClaimsTemporary workCasual workWork at office$29 - $52 per hour
UnitedHealth Group is seeking a qualified Registered Nurse in Massachusetts to perform clinical coverage review services. As part of this role, you will communicate benefit determinations and work closely with healthcare providers to explain coverage. We offer telecommuting...Remote jobClaimsHourly pay$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals) Experience: Open to various clinical backgrounds... ...State RN license*** Location: Remote (can sit anywhere in the US as long as... ...RNs as the project expands. 4. Claims assessment and adjudication. 5....Remote workClaimsLocal areaImmediate startFlexible hours- CareFirst, Inc. is seeking a full-time RN Clinical Medical Review Nurse to work remotely from the greater Baltimore metropolitan area. This role involves managing the review of professional and institutional claims, analyzing medical information for enrollment eligibility...Remote jobClaimsFull timeWork experience placement
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain... ...conducts research, analyzes claims data, applies knowledge of client... ...to work independently in remote setting with minimum supervision... ...*** Active unrestricted RN license #J-18808-Ljbffr...Remote workClaimsFlexible hours$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting... ...applications This is a 100% remote role, and requires robust internet... ...authorization data with post-service claims validation, we're creating a transparent...Remote workClaimsFull timeFlexible hoursShift work$28 - $33 per hour
...Appeals Clinical Reviewer The Appeals Utilization Review Nurse reviews... ...authorization decisions, and claims outcomes. This role applies... ...role and is performed fully remotely. Responsibilities Review... ...employee and dependents) Short and long-term disability Health...Remote jobClaimsPermanent employmentContract workTemporary workMonday to FridayWeekday work- ...Nurse RN 5 – Medical Necessity & Post-Service Clinical Review Nurse We are seeking an experienced Registered Nurse (RN) to support post-service clinical reviews and retrospective claims evaluations. This role is responsible for reviewing medical necessities, coding...Remote workClaimsContract work
- Actalent is seeking a team of UM/Appeals LPNs for a fully remote role. The Appeals Clinical Reviewer evaluates member and provider appeals for medical necessity, authorization decisions, and claims outcomes, applying guidelines and Medicaid regulations to ensure fair and...Remote jobClaimsPermanent employmentContract workWork from home
$69.3k - $78k
...integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and... ...The position requires an active RN license and a minimum of five years... ...documenting findings, all in a remote work environment. This role...Remote jobClaims- CareFirst, Inc. is seeking a full-time Clinical Medical Review Nurse to work remotely. In this role, you will manage the... ...of professional and institutional claims and provider appeals to determine... ...Nursing or equivalent experience, RN licensure in VA, DC, or MD, and at...Remote jobClaimsFull time
$29 - $52 per hour
...on some tough challenges. Primary Responsibilities Perform clinical coverage review services, which require interpretation of state and federal... ...Required Qualifications Associate's degree Current unrestricted RN license in the state of Massachusetts 3+ years of experience...Remote workClaimsHourly payMinimum wageFull timeWork experience placementLocal area$2,210 per week
...vision, long-term care, short-term disability,... ...Work-life balance. Remote/hybrid setting (... ...individual will utilize clinical knowledge and... ...to a second level reviewer. This individual interfaces... ..., benefit and claim concerns, and validation... ...is not limited to RN, LMSW, LMHC....Remote workClaimsFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours$45.29 - $84.11 per hour
...Rotating weekends Hybrid/Remote Summary The purpose... ...and accurate clinical information to all... ...continued hospital stays. This role will require... ...obstacles and deny claims and escalating any... .... Responsibilities Review all inpatient... ...related field. Current RN License in Connecticut...Remote workClaimsHourly payDaily paidPart timeShift workNight shiftRotating shift- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These... ...determinations as to the validity of health claims and levels of payment in meeting... ...Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS...Remote workClaimsPermanent employmentWork at officeLocal area
$35 - $40 per hour
...service offerings for clinical, case management,... ...payment integrity, claims cost containment, and... ...Job title: RN Utilization Management Reviewer Job Description:... ...This is a fully remote work at home role. You... ...Life Insurance ~ Short-Term and Long-Term Disability...Remote workClaimsHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- ...Clinical Auditor Registered Nurse We are seeking... ...medical record reviews, billing compliance... ...skills. This is a remote position with occasional... ...guidelines. Stay current on clinical... ...Requirements RN license preferred;... ...1 year of Medicaid claims review, billing compliance...Remote workClaimsLocal area
$69.38k - $92.28k
Overview As a Clinical Appeals RN, you will review denied service authorizations and claims, evaluate medical necessity, and work closely... ...implementation of best practices Stay updated on regulatory changes... ...a combination of office and remote settings. EEO Statement MVP is...Remote workClaimsWork at office$32.5k
...shift Registered Nurse for our Short Stay/ Surgical Observation Unit!... ...Martha Jefferson has under a 12.6% RN Turnover rate Patient... ...Nursing Orientation Specialty Clinical Track Residency Professional... ...that are available as remote work, Sentara Health employs...Remote workFull timeTemporary workRelocation packageShift workWeekend workDay shift$78k - $88k
...individual for a Nurse Reviewer (RN) who will be... ...responsible for performing clinical reviews to... ...trainings and meetings to stay current on... ...to review multiple claim types to maintain... ...not a contract or short-term role. Health... ...work schedule. Remote position;...Remote workClaimsPermanent employmentFull timeContract workTemporary workMonday to FridayFlexible hours$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals... ...also handle clinical claim appeals from providers.... ..., continued stay, reduction, termination... ...and prepare cases for review and appeals. Minimum Qualifications...Remote jobClaimsFull timeMonday to FridayShift work$32.5k
...Coordinatorfor Surgery Unit 1- Observation Short Stay .This is a Full Time Night (1... ...specialty area and provides clinical leadership for the delivery of... ...Jefferson has under a 12.6% RN Turnover rate Patient... ...that are available as remote work, Sentara Health employs...Remote workFull timeTemporary workShift workNight shiftWeekend work$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused... ...primarily performs medical claims audit reviews. As a MR Nurse... ...Commercial Payers. You will work remotely in a fast paced and dynamic... ...Active unrestricted RN license in good standing, is...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work$35 - $62.5 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL... ...auditing of inpatient claims. Employing both industry... ...and APR-DRG coding reviews to verify the accuracy... ...Insurance along with Short-term disability and Long... ...work independently in a remote environment and...Remote workClaimsHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Clinical Claims Review (Short-Stay). Be the first to apply!
- rn manager Minneapolis, MN
- icu rn Minneapolis, MN
- part time clinic rn Minneapolis, MN
- clinic registered nurse rn Minneapolis, MN
- prn rn Minneapolis, MN
- registered nurse office Minneapolis, MN
- fema rn Minneapolis, MN
- rn case manager Minneapolis, MN
- new grad rn work from home Minneapolis, MN
- travel registered nurse l&d Minneapolis, MN



