Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote DRG Nurse Appeals Specialist

$90k - $99k

Gainwell Technologies LLC

Florida, NY
  • Remote job

Gainwell Technologies LLC is seeking a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform appeal-related duties, including analyzing and responding to appeals, participating in hearings, and maintaining current clinical knowledge. The role requires an active RN license, relevant coding certifications, and strong communication skills. The position offers a salary range of $90,000.00 - $99,000.00 per year, with additional flexible benefits including a 401(k) match and health coverage. This is a remote role with up to 25% travel expected. #J-18808-Ljbffr Gainwell Technologies LLC

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote DRG Nurse Appeals Specialist in Florida, NY vacancy
  • $90k - $99k

     ...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes...  ...Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA... 
    Remote work
    Full time
    Work from home
    Flexible hours

    Gainwell Technologies

    Florida, NY
    1 day ago
  • $90k - $99k

    A leading healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage in hearings, both...  ...must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career... 
    Remote work
    Flexible hours

    Gainwell Technologies

    Florida, NY
    1 day ago
  • $80k - $90k

     ...The Medical Review Clinical Appeals Auditor (RN) is responsible...  ...with CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding may be necessary. Strong...  ...to work independently in remote setting with minimum supervision...  ...good standing and diversified nursing experience providing direct care... 
    Remote work
    For contractors
    Immediate start
    Work from home
    Home office
    Flexible hours
    Shift work

    The Rawlings Group

    Plantation, FL
    2 days ago
  • $90k - $110k

     ...DRG Revenue Integrity Auditor Remote CareNational is looking for an experienced DRG Revenue Integrity Auditor ! Ideal candidates will have...  ...party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). ~ Prior experience working as a CDI/Coding auditor... 
    Remote work
    Immediate start
    Work from home

    CareNational

    Plano, TX
    1 day ago
  •  ...Remote Appeals Pharmacist – Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy...  ...supporting appeal outcomes. Collaborate with physicians, nurses, and medical directors during case reviews. Track and... 
    Remote work
    Work from home

    Pharmacy Careers

    Fargo, ND
    1 day ago
  • $85k - $95k

     ...Clinical Validation Nurse At MedReview, our mission is to bring...  ...integrity solutions including DRG Validation, Cost Outlier and Readmission...  ...CCS (Certified Coding Specialist) or CIC (Certified Inpatient...  ...applications at the same time Remote Work Requirements: High... 
    Remote work
    Full time
    Monday to Friday

    Med Review Inc

    United States
    3 days ago
  • $67.32k - $133.71k

     ...for an experienced professional to work remotely from within the greater Baltimore...  ...activities. PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and...  ...obtaining clinical opinions from physician specialists, to determine if adverse decisions are... 
    Remote work
    Work experience placement
    Work at office
    Immediate start

    CareFirst BlueCross BlueShield

    United States
    1 day ago
  •  ...as a hospital liaison with external third-party payors to appeal denied claims. Works closely with Physician advisor team to...  ...management team. Job Description Clinical Appeals Nurse - Full Time Remote - Jefferson Health Articulates the job's main responsibilities... 
    Remote work
    Daily paid
    Full time
    Temporary work
    Part time
    Flexible hours
    Shift work

    Thomas Jefferson University Hospital

    United States
    3 days ago
  • $50 per hour

     ...We are looking for a Clinical Appeals Nurse to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate...  ...Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work on... 
    Remote work
    Hourly pay
    Full time
    Part time
    For contractors
    Flexible hours

    DataAnnotation

    Charleston, WV
    1 day ago
  •  ...Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit... 
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    4 days ago
  • $238k - $357.5k

     ...to start Caring. Connecting. Growing together. Work at home!The Appeals and Grievances Medical Director is responsible for ongoing...  ...UnitedHealthcare associated companies.You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough... 
    Remote work
    Minimum wage
    Work experience placement
    Local area
    Work from home

    UnitedHealth Group

    Cypress, CA
    10 hours ago
  • $52 per hour

     ...Hiring for RN - Appeals (Remote Role) in Somerville, MA Shift : Days 5x8 (08:00 - 17:00) Duration : 13 Weeks (Temp to Perm)...  ...AHA) ~100% remote ~ Looking for a registered nurse with payor experience (Commercial and Medicaid) ~ Would like... 
    Remote work
    Permanent employment
    Temporary work
    Shift work

    Pacer Group

    United States
    10 hours ago
  •  ...an experienced IP Coder to perform inpatient coding, including DRG assignment and validation. You will work with the CDI team, Coding...  ..., and strong knowledge of medical terminology and anatomy. Remote work is available with secure, high-speed internet requirements.... 
    Remote work

    Universal Health Services

    Edinburg, TX
    1 day ago
  • $45 - $63 per hour

     ...Description A-Line Staffing is now hiring Full-time RN Grievance and Appeals Supervisor in the Los Angeles, CA area. The RN Grievance and...  ...required per business needs Location: ·       Primarily Remote work with Occasional in office visits required in Los Angeles,... 
    Remote work
    Hourly pay
    Full time
    Casual work
    Work at office
    Immediate start
    Monday to Friday

    A-Line Staffing Solutions

    Los Angeles, CA
    2 days ago
  • $36 - $40 per hour

     ...exclusive features. At Norwood we’re forging our own path. We’re a remote-first staffing and consulting company specializing in mid-...  ...long term fulfillment in your coding career. If you are an Appeals and Denials Nurse looking for a new opportunity to sharpen your skills, we... 
    Remote work
    Permanent employment
    Full time
    Work visa

    Norwood

    New York, NY
    4 days ago
  •  ...Universal Health Services is seeking an Inpatient Coder to ensure DRG accuracy and timely coding of inpatient records. You will use...  ...team, Coding Manager, Business Office and Case Management.This remote role requires strong medical terminology knowledge, hospital coding... 
    Remote work
    Work at office

    Universal Health Services

    Edinburg, TX
    1 day ago
  •  ...Overview Job Title: Registered Nurse – Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working hours: Day Shift Job Type: Subcon Pay Rate: Negotiable Position Description The Quality Analyst... 
    Remote work
    Contract work
    Day shift

    Compunnel

    Florida, NY
    1 day ago
  • Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree... 
    Remote job

    Blue Cross Blue Shield of Arizona

    Phoenix, AZ
    3 days ago
  •  ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's ~ Start Date ~ Unavailable ~...  ...Appeals Processor III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is responsible for... 
    Remote work
    Contract work
    For contractors
    For subcontractor
    Shift work

    Ghost RX

    Orlando, FL
    2 days ago
  • A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching... 
    Remote job

    Healthfirst

    New York, NY
    4 days ago
  •  ...seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and guideline compliance.You will report to the Manager, Payment Integrity. The role involves auditing inpatient records,... 
    Remote work

    Humana

    Denver, CO
    1 day ago
  • $45 per hour

    SPECTRAFORCE is seeking a Clinical Appeals Specialist to handle member-generated appeal processes remotely from California. The role involves reviewing medical records...  ...will have strong managed care and clinical nursing experience, exceptional attention to detail, and... 
    Remote job
    Hourly pay

    SPECTRAFORCE

    California, MO
    3 days ago
  • UnitedHealth Group's Optum is seeking a Clinical DRG RN auditor to apply MS-DRG/APR-DRG coding and CMS guidelines to inpatient claims. Remote work is available nationwide; you will...  ...coding proficiency are essential. #J-18808-Ljbffr University of Minnesota School of Nursing
    Remote job

    University of Minnesota School of Nursing

    Minneapolis, MN
    5 days ago
  •  ...Minnesota, United StatesCompany: UnitedHealth GroupPosted: 2026-08-10UnitedHealth Group is seeking an experienced Inpatient DRG Coder to join the remote coding team. You will assign ICD-10-CM/PCS and DRG codes for facility services, adhering to official coding guidelines... 
    Remote work

    UnitedHealth Group

    Saint Paul, MN
    1 day ago
  •  ...Appeals Nurse The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services...  ..., skills, and experience. Work Location: We are open to remote work in the following approved states: Colorado, Florida, Georgia... 
    Remote work
    For contractors
    Local area
    Immediate start

    WPS Health Solutions

    United States
    1 day ago
  •  ...integrity by reviewing inpatient claims for coding accuracy and DRG assignment. You report to the Manager, Payment Integrity and collaborate...  ...experience, with strong DRG knowledge and CDI/SOI concepts. Remote/hybrid work options are available within the Humana network.#J-1... 
    Remote work

    Humana

    New York, NY
    1 day ago
  • $70k - $80k

    Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider appeals. Candidates must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience... 
    Remote job
    Full time
    Contract work
    Monday to Friday

    Piper Companies

    Cary, NC
    5 days ago
  •  ...A leading healthcare organization in Boston is seeking a detailed-oriented professional to conduct inpatient DRG reviews. The role requires an RN or LVN and an inpatient coding certification within 4-6 months of hire. Responsibilities include performing comprehensive DRG... 
    Remote work

    Zelis Healthcare

    Boston, MA
    10 hours ago
  • A national healthcare company is seeking a Senior Appeals Representative to manage and resolve appeals and grievances. This remote role requires strong analytical skills and the ability to communicate effectively with members and providers. Candidates must have a High... 
    Remote work
    Work at office

    UnitedHealthcare

    Tampa, FL
    3 days ago
  • A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy...  ...for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team to deliver... 
    Remote work

    Global Channel Management

    Chattanooga, TN
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote DRG Nurse Appeals Specialist. Be the first to apply!