Remote DRG Nurse Appeals Specialist
$90k - $99kGainwell Technologies LLC
- 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
$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex... ...Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA...Remote workFull timeWork from homeRelocation packageFlexible hours$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 jobFlexible hours- ...Santa Barbara Cottage Hospital is seeking a Clinical Nurse Specialist to resolve complex clinical denials and enhance reimbursement outcomes through evidence-based appeals. Your role includes analyzing denial trends, collaborating with teams, and improving clinical review...Remote work
$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeShift workWeekend work- Elevance Health is looking for a Nurse Appeals Associate to work in a hybrid environment. This role involves researching and resolving administrative appeals, as well as contributing to compliance audits. The ideal candidate must have a current LPN/LVN license and at least...Remote job
- ...To support the appeals process, the full-time remote Wisconsin Licensed Appeals Nurse will examine medical records and claims for first-level appeal cases, ensuring compliance with Medicare guidelines and collaborating with Appeals Examiners to facilitate timely redeterminations...Remote workFull time
- ...Cambia Health Solutions is seeking an Appeals Clinician I to join their Clinical Services team. This role requires a Bachelor's Degree in Nursing and clinical experience to resolve member and provider appeals, applying nursing expertise and clinical judgment. The position...Remote workWork from home
$80k - $90k
...The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...with CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding may be necessary.... ...ability to work independently in remote setting with minimum supervision... ...good standing and diversified nursing experience providing direct care...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- ...Grievances And Appeals Nurse Pride Health is hiring a Grievances and Appeals Nurse for a well-known client! (Remote Contract) Schedule: 5x8s Day shift Contract: 6 months Pay... ...terminology, ICD, CPT, HCPCS, and DRG codes Pride-Health offers eligible...Remote workContract workWork experience placementLocal areaDay shift
$40 - $47 per hour
...Clinical Documentation Quality Improvement (CDQI) Nurse Specialist to work part‑time (minimum 15 hours per week) on a remote basis. Responsibilities Conduct timely,... ...reimbursement and clinical severity for DRG‑based payer patients. Demonstrate understanding...Remote workHourly payPart time$76.5k - $103.5k
Cambia Health Solutions is looking for an Appeals Clinician I, focusing on resolving member appeals with your clinical expertise. You... ...opportunity. The ideal candidate should have a Bachelor's Degree in Nursing along with an active RN license. The role offers a competitive...Remote jobWork from homeFlexible hours- Cambia Health Solutions is looking for an Appeals Clinician I to join their Clinical Services team. This role focuses on ensuring compliance... ...reviews. Ideal candidates will have a Bachelor's Degree in Nursing and essential clinical experience. The position offers work-...Remote jobWork from home
- ...Clinical Nurse Specialist At Aspirion, our mission is simple and meaningful: to help healthcare... ...into clear, evidence-based appeal arguments that drive reimbursement outcomes... ...awareness of confidentiality obligations US remote-based colleagues are not permitted to...Remote work
- Jefferson Health is seeking a Clinical Appeals Nurse to be a part of their team, working fully remote. This role involves reviewing payor denials, writing appeals, and coordinating with third-party payors to advocate for patient claims. Qualified candidates will hold a...Remote job
- A healthcare solutions firm is looking for a Clinical Appeals Nurse (RN) to support revenue cycle operations by reviewing denied claims. This remote position requires an active RN license and 3-5 years of clinical nursing experience. Responsibilities include assessing...Remote job
$85k - $90k
...plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records... ...commercial payers, InterQual, MCG, and Trend Health Partners Provide appeal responses for claims of the above types utilizing industry...Remote jobWork at office$113.77k - $215.57k
Registered Nurse - Diagnosis Related Group Coding Auditor... ...in a hybrid model (remote and office). The ideal... ...-expense spending. The DRG Coding Auditor Principal... ...that disputes or appeals may only be reviewed by... ...as a Certified Coding Specialist, CIC as a Certified Inpatient...Remote workDaily paidWork at officeLocal area1 day per week$29 - $52 per hour
...UnitedHealth Group is seeking a Remote Registered Nurse (RN) in California to handle appeals and medical record reviews. The ideal candidate should possess a current RN license and have at least 2 years of clinical experience. This role also requires familiarity with...Remote workHourly pay$30 - $34 per hour
...complex claim reviews, the Companies are required to use Registered Nurses ("RNs"). Clinical decisions will be based on CMS policies/... ...applicable. Our staff will perform this work for Medical Reviews, Appeals, and/or Prior Authorization requests. Qualified Staff and...Remote workHourly payContract work- ...WPS Health Solutions is seeking an Appeals Nurse to examine medical records for first-level appeal cases, ensuring services meet Medicare coverage guidelines. With options for remote work, the ideal candidate will have a nursing degree and active RN license, accompanied...Remote work
$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 workImmediate startWork from home$29 - $52 per hour
...Texas Health Institute is seeking a motivated RN to assess appeals and medical records, ensuring coverage and billable criteria. This role offers remote work flexibility, primarily within EST and CST hours. The candidate should have a valid RN license, 2+ years of clinical...Remote workHourly pay$248.5k - $373k
UnitedHealth Group is seeking an Appeals and Grievances Medical Director responsible for reviewing and adjudicating cases in various health... ...clinical practice and Quality Management. This position offers remote work flexibility, allowing for a dynamic work environment where...Remote job- ...WPS Health Solutions is seeking an Appeals Nurse in Michigan to examine medical records and claims for appeal cases. This role involves collaboration... ...attention to detail are essential. This opportunity offers remote work options and various benefits from day one. #J-18808-...Remote work
- ...WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeal cases. This role collaborates... ...degree, an active RN license, and strong communication skills. Remote work options are available, and candidates are expected to...Remote work
- Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department: Clinical Appeals Reports To: Director of Clinical Appeals Position Overview The Clinical Appeals Nurse supports HBiz’s revenue cycle operations by reviewing denied claims for clinical accuracy and...Remote work
$66k - $68k
...WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeal cases. In this role, you will collaborate with examiners to ensure medical necessity is determined in compliance with Medicare guidelines. Experience in clinical...Remote work$85k - $95k
...integrity solutions including DRG Validation, Cost Outlier and Readmission... .... We are seeking a registered nurse with experience in clinical... ...CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder... ...applications at the same time Remote Work Requirements High speed...Remote workFull timeMonday to Friday$76.5k - $103.5k
...Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise in resolving member and provider appeals. This... ...health care easier for members and requires a Bachelor's Degree in Nursing, an active RN license, and relevant clinical experience. The...Remote work- ...WPS Health Solutions in Omaha is seeking an Appeals Nurse to examine medical records and claims for appeals. This role involves reviewing... ...experience, and strong communication skills. The position offers remote work options and benefits including health insurance, paid...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote DRG Nurse Appeals Specialist. Be the first to apply!
- clinical nurse specialist Florida, NY
- remote quality assurance Florida, NY
- remote accounts payable Florida, NY
- remote gis Florida, NY
- entry level remote Florida, NY
- remote medical billing part time Florida, NY
- sales engineer remote Florida, NY
- remote isolated Florida, NY
- remote hr coordinator Florida, NY
- remote program manager Florida, NY

