Remote Clinical Validation Auditor - Healthcare Claims
ExlService Holdings, Inc.
- Remote job
ExlService Holdings, Inc. is seeking a Clinical Validation Auditor to review inpatient records and validate billed DRG codes. You will apply clinical judgment to ensure accuracy and fairness in claims coding while working remotely. Ideal candidates are licensed nurses with experience in inpatient care and a keen eye for detail, who can identify discrepancies and potential overpayments, contributing to quality patient data and compliant billing practices. #J-18808-Ljbffr ExlService Holdings, Inc.
- ...the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you’ll use your clinical... ...in industries including insurance, healthcare, banking and financial services,...Remote workClaimsFull time
$35 - $62.5 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS... ...of inpatient claims. Employing both industry... ...proprietary tools, you will validate ICD-10 diagnosis and... ...data entry Healthcare claims experience... ...work independently in a remote environment and deliver...Remote jobClaimsHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package- Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records, ensuring clinical documentation... ...locations are included. Requires extensive experience in claims auditing and clinical documentation improvement, with...Remote jobClaims
- Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient records and validate DRG coding. The role... ...environment. Requires an active RN license and 10+ years in claims auditing or related fields, with 5+ years in MS-DRG, AP-...Remote jobClaimsFlexible hours
- ...of inpatient care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you’ll use your clinical judgement to review medical records,...Remote workClaims
$90k - $105k
...solutions that solve some of healthcare’s most complex... ...individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews... ...codes for inpatient claims. Consistently... ...expect in this role Remote within the U.S. May...Remote workClaimsFull timeContract workFlexible hours- UnitedHealth Group is seeking a Clinical DRG RN auditor to apply expert MS-DRG/APR-DRG coding knowledge and ICD-10 guidelines in inpatient claims audits. This remote role allows telecommuting from anywhere in the U.S. with a sign-on bonus for external applicants. Responsibilities...Remote jobClaimsRelocation package
$70.8k - $123.8k
Clinical Nurse Auditor Position Description CGI is one of the world... ...and necessity of healthcare services provided to members... ...and outpatient claims, evaluate medical necessity, validate clinical services, and... ...practices. This position is remote within the United States...Remote workClaimsWork at officeLocal area$86.56k - $155.81k
...Title: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Anticipated... ...Diagnosis Related Group (DRG) paid claims. How you will make an impact:... ...improving lives and communities - and making healthcare simpler. We are a Fortune 25 company...ClaimsFull timeTemporary workWork experience placementWork at officeLocal area1 day per week$45 - $50 per hour
...Clinical Documentation Consultant (CDI) DRG Validation / Auditor Immediate need for a talented Clinical Documentation Consultant... ...potential and is located in US(Remote). Pay Range: $45 - $50/hour.... .... Our client is a leading Healthcare Industry and we are currently...Remote workContract workLocal areaImmediate start$69.3k - $78k
A healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and Commercial Payers. The position requires an... ...and documenting findings, all in a remote work environment. This role offers...Remote jobClaims$85k - $95k
...accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading... ...solutions including DRG Validation, Cost Outlier and... ...consider nurses with inpatient claims auditing experience or case... ...applications at the same time Remote Work Requirements High...Remote workClaimsFull timeMonday to Friday- ...classified as hybrid, onsite or remote. While the majority of our... ...to: Customer Service, Claims Processors, and Correspondence... .... PURPOSE OF THE JOB The Clinical Trainer and Auditor is responsible for planning... ...remote employees Develop valid exercises designed to provide...Remote jobClaimsFull timeWork experience placement1 day per week
$69.3k - $78k
...Medical Review Nurse II - Clinical Validation At Performant, we’re... ...premier independent healthcare payment integrity... ...primarily performs medical claims audit reviews. As a... ...experienced medical auditors and coders performing... .... You will work remotely in a fast paced and dynamic...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work- ...Payment Integrity Drg Coding & Clinical Validation Analyst The Payment... ...and audits acute inpatient claims. Integrates medical chart coding... ...by supporting the Lifetime Healthcare Companies' mission and values... ...There may be opportunities for remote work on all jobs posted by...Remote workClaimsWork experience placement
- UnitedHealth Group is hiring a Clinical DRG RN auditor to apply MS-DRG/APR-DRG knowledge, ICD-10 guidelines, and AHA Coding Clinic guidance in inpatient claim audits. You will validate codes, DRG assignments, and discharge status to identify overpayments and compose rationales...Remote jobClaims
$34.23 - $61.15 per hour
About This Role As a Clinical DRG RN Auditor at UnitedHealth Group, you will leverage your expertise... ...coding methodologies to audit inpatient claims, ensuring accuracy and identifying... ...Group UnitedHealth Group is a leading healthcare provider committed to delivering exceptional...ClaimsHourly payFull timeTemporary workRelocation packageDay shift$85k - $95k
RCM Healthcare Services is seeking a DRG Coding Reviewer... ...support inpatient coding validation and payment integrity initiatives. This remote, full-time role offers... ...will review inpatient claims to validate ICD-10 coding... ..., perform coding and clinical validation reviews, and...Remote jobClaimsFull time$90k - $115k
A healthcare intelligence company is seeking a DRG Reviewer to conduct payment validation reviews. The ideal candidate will possess a nursing... ...least two years of inpatient claims auditing experience.... ...medical records, providing clinical support, and ensuring compliance...Remote jobClaimsFlexible hours$71.1k - $97.8k
...Certified medical coding auditor to review inpatient hospital claims for proper... ...Coding Auditor extracts clinical information from a... ...Assign and validate ICD-10-CM, ICD-10-PCS... ...Travel: While this is a remote position, occasional... ...wellness and smart healthcare decisions for you...Remote workClaimsFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayShift work$71.1k - $97.8k
...Inpatient Medical Coding Auditor extracts clinical information from a... ...inpatient hospital claims for proper reimbursement... ...impact WORK STYLE: Remote/work at home. While this... ...wellness and smart healthcare decisions for you and... ...decisions only on valid job requirements. This...Remote workClaimsBi-weekly payContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$59.3k - $80.9k
...The Medical Coding Auditor reviews medical claims submitted against medical... ...documentation for clinical indicators to ensure... ...WORK STYLE: Remote/Work at home; minimal... ...wellness and smart healthcare decisions for you and... ...employment decisions only on valid job requirements....Remote workClaimsFull timeTemporary workApprenticeshipWork from home- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical... ...audits, and collaboration with a team of auditors to document findings and input data... ...position is full-time (40 hours/week) with remote work options in Massachusetts and...Remote jobClaimsFull timeLocal area
$45.67 per hour
...auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits... ...for auditing outpatient/specialty claims and documenting the results of those... ...complex claim types gained from extensive healthcare auditing experience. Suggests,...ClaimsHourly payContract workWork at office$31.25 - $38.46 per hour
Overview This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs... ...care. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus...ClaimsHourly payWork at office$30.5k - $42.5k
A leading healthcare solutions provider is looking for a Medical Claims Auditor to work remotely from Texas. The ideal candidate will review and analyze medical claims for accuracy and compliance, validate coding, and identify errors. With at least three years of relevant...Remote workClaims- A healthcare services provider is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves extracting clinical information from medical records and ensuring proper reimbursement for inpatient hospital claims. Ideal candidates will have at least four...Remote workClaimsContract work
$71.1k - $97.8k
A leading healthcare company is seeking an Inpatient Medical Coding Auditor to analyze clinical data and ensure accurate coding for reimbursement. This remote position involves reviewing inpatient hospital claims, requiring RHIA, RHIT, or CCS certification. Ideal candidates...Remote workClaims- Molina Healthcare is seeking a registered nurse with inpatient claim review experience to ensure diagnoses, procedures, revenue codes, and DRG assignments accurately reflect the documented care and billed charges. You will apply ICD-10, DRG and revenue code guidelines,...Remote jobClaims
$90k - $100k
...Clinical Researcher Remote Garner's mission is to transform the healthcare economy, delivering high-quality and affordable care for... ...maintain Garner's proprietary claims-based physician performance... ...procedures Create and validate measures using proprietary technical...Remote workClaimsWork at officeWork visaFlexible hours
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