Remote Home Health Medical Review Nurse Auditor
Machinify, Inc.
- Remote job
Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy, and regulatory awareness. You will review claims, reference guidelines, and participate in the appeals process while staying current with coding standards and home health practices. This position is remote within the US. #J-18808-Ljbffr Machinify, Inc.
$78.4k - $107.8k
...caring community The Nurse Auditor 2 performs clinical... ...to ensure that medical record documentation... ...experience to conduct reviews of provider codes and... ...impact WORK STYLE: Remote/Work at Home. While this is a remote... ...mother-baby, behavioral health, SNF, care manager/...Remote workWork from homeMedicalBi-weekly payFull timeTemporary workApprenticeshipHome officeMonday to Friday- ...Job TitleRegistered Nurse (RN) for Critical... ...receiving home and community-based... ...be responsible for reviewing and evaluating critical... ...such as Community Health Choices, Act 150,... ...each participant's medical and functional needs... ...to support remote and hybrid work functions...Remote workWork from homeMedical
$33 - $46 per hour
...Utilization Review Nurse Auditor Fully Remote Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage... ...utilization review services and approving care that is medically necessary and appropriate according to evidenced based...Remote workMedicalHourly payFull timeLocal areaMonday to Friday- ...Rehabilitation Therapy, and Nursing. Job Description This... ...The role involves performing medical record reviews and data extraction for the... ...transition to working from home four days a week, depending... ...meetings are mandatory, with remote work on other days. Additional...Remote workWork from homeMedicalWork at office
- ...HEDIS Auditor RN/LPN Integrated Resources, Inc... ...Rehabilitation Therapy and Nursing. Job Description:... ...for performing medical record reviews and data extraction for... ...migrating to working from home 4 days a week. How... ...candidate must attend and remote other days....Remote workWork from homeMedicalContract work
$90k - $145k
...documentation in the Medical Record. Seeking... ...with a HCS-D – Home Care Coding Specialist... ...Specialist-Clinical. Remote position in New... ...assignment. 2. Full review of CDI suggested... ...accredited School of Nursing. Bachelor's Degree... ...provided by Northwell Health. Candidates should...Remote workMedicalHourly payFull time- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements... ..., and the ability to work in a remote environment. Comprehensive...Remote workWork from homeMedicalContract work
$54.1k - $116.77k
...’re building a world of health around every individual... ...Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management... ...across a broad range of medical specialties Evaluate... ...preferred Work from Home Requirements: You must...Remote workWork from homeMedicalHourly payFull timeTemporary workWork at officeLocal area$78.91k - $105k
...Benefits : ~ Medical, Dental, Vision, Pharmacy... ...billing coordinator and/or auditor. # Certified... ...preferred. #2 years’ health insurance industry experience... ...# Prior experience in review of medical records.... ...connection required to support remote or hybrid work. Must be...Remote workWork from homeMedicalHourly payFull timeWork at officeAfternoon shift$65k - $78k
...Gainwell It takes great medical minds to create... ...Role In Our Mission Review admissions, procedures,... ...Assist in training new nurses, provide feedback, and... ...Expect In This Role Home-based position. High... ...match, comprehensive health benefits, and educational...Remote workWork from homeMedicalFull timeWork at officeFlexible hours- ...Friend Back Remote Work from Home Share This Page... ...Location: Johns Hopkins Health Plans, Hanover,... ...MD 21076 Category: Nursing Schedule: Day Shift... ...As a Utilization Review Registered Nurse for... ...member benefits and medical criteria to determine...Remote workWork from homeMedicalFull timeLocal areaMonday to FridayDay shift
- ...Description University Health Network is seeking a Full-Time Coding Auditor. This role requires... ...-Friday and is a remote position with occasional... ...requirements when working from home. Candidate must be... ...Performs audits and medical chart reviews contributing to the...Remote workWork from homeMedicalFull timeWork at officeMonday to Friday
- ...Case Management/Utilization Review Pre-Cert Review* Prior Authorizations... ...Stay Reviews Determine Medical Necessity per Evidence-Based... ...and billing Department of Health DRG (Diagnosis Related... ...Goals Additional Skills remote UR work CA and Medi-Cal experience...Remote workMedical
- ...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 workMedicalFull time
$27.02 - $48.55 per hour
...Prior Authorization Reviewer Position Purpose:... ...requests to determine medical necessity of service... ...flexibility to work remotely from their home anywhere within the state... ...and behavioral health service requests for... ...Accredited School of Nursing or Bachelor's degree...Remote workWork from homeMedicalHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER,... ...' experience in hospital, home health, or hospice care. Clinical... ...Experience in Utilization Review or case management roles.... ...to work independently in remote settings. Must be able...Remote workMedicalFlexible hours
$27.02 - $48.55 per hour
...Performs concurrent reviews, including determining member's overall health, reviewing the type of... ...delivered, evaluating medical necessity, and contributing... ...: This role is fully remote/work from home. The role will support... .... RN compact nursing licensure is preferred...Remote workWork from homeMedicalHourly payFull timePart timeWork at officeMonday to FridayFlexible hoursWeekend work- ...Nurse Auditor Full-time Company Description Healthcare Job... ...Experience Proven knowledge of medical and surgical procedures and... ...search). Familiarity with health care documentation systems.... ...Demonstrated competency in claim review and experience in using...Remote workMedicalFull timeWork at office
- ...growing healthcare platform, the full-time Medical Review Nurse will ensure compliance with CMS... ...maintain data security while working remotely. Key Responsibilities Review DMEPOS orders... ...ensure proper handling of Protected Health Information (PHI) Required Qualifications...Remote workMedicalFull timeFlexible hours
$95k - $110k
...receive an alert: DRG Nurse Reviewer Appeals and Hearings- Remote Date: Aug 30, 2026... ...) It takes great medical minds to create... ...and in the primary home residency, active compact... ...Medical Auditor (CPMA) required 5+... ...match, comprehensive health benefits , and educational...Remote jobWork from homeMedicalFull timeRelocation packageFlexible hours- ...Registered Nurse Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review... ...Qualifications: Minimum of 3 years acute medical Care Management/Utilization Review... ...in a hospital setting (experience in health plans or medical groups is not...Remote workMedical
- Actalent is seeking a Concurrent Review Nurse to conduct concurrent reviews, evaluate medical necessity, and contribute to discharge planning. The role emphasizes... ...on utilization processes. The position is remote and contract-to-hire, based in Texas and supporting...Remote jobMedicalContract work
$61.05k - $98.33k
...Itemization Review Nurse The Itemization Review Nurse provides a summary... ...on a UBIB submitted by a medical facility to determine accuracy... ...of billed charges. This is a remote position. Essential... ...Vision, Long Term Disability, Health Savings Account, Flexible Spending...Remote workMedicalFull timeWork at officeFlexible hours$71.1k - $97.8k
...Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a minimum of two years...Remote workWork from home$1,966 per week
...first 25 applicants Nurses - are you looking... ...able to work from home 50% of the time... ...personalized managed health care, focused on... ...benefits, including medical, dental, vision,... ...Work-life balance. Remote/hybrid setting (once... ...to a second level reviewer. This individual...Remote workWork from homeMedicalFull timeTemporary workPart timeWork at officeMonday to FridayFlexible hours- ...Job Opportunity for Remote Nurse in Michigan This position is a remote... ...completing post-acute reviews for inpatient rehab and skilled... ...experience in patient care and health care delivery processes One... ...Clinical experience in ICU, ER, or medical surgical unit preferred...Remote workMedical
$7.5k
...organizing and providing nursing care to patients... ...Essentia Health St. Mary's- Detroit... ...the submission and review of in-depth documentation... ...0.6 Possible Remote/Hybrid Option:... ...comprehensive benefits include medical, dental, vision,... ...at work and at home, we provide flexible...Remote workWork from homeMedicalPart timeLocal areaWorldwideFlexible hoursShift workNight shiftWeekend work$38.22 - $57.33 per hour
...organizing and providing nursing care to patients... ...Essentia Health St. Mary's- Detroit... ...the submission and review of in-depth documentation... ...0.5 Possible Remote/Hybrid Option:... ...comprehensive benefits include medical, dental, vision,... ...at work and at home, we provide flexible...Remote workWork from homeMedicalPart timeLocal areaWorldwideFlexible hoursShift workWeekend work$82.72k - $108.57k
...Associate, Risk Adjustment Auditor to join our Risk... ...Oscar is the first health insurance company built... ...Location: This is a remote position, open to candidates... ...completed from your home office, occasional travel... ...but not limited to: medical record reviews to report ICD-10-CM...Remote workWork from homeMedicalFull timeWork experience placementHome office$1,851.96 per month
...Client Name Lee Health-Corporate Center... ...Travel Offering Nursing Profession... ...Specialty Utilization Review Job ID 38245... ...Experience with electronic medical records (EMR), specifically... ...some experience with remote work. Responsibilities...Remote workMedicalWeekly payContract workLocal areaMonday to FridayShift workWeekend work
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