Remote DRG Nurse Reviewer & Appeals Specialist
$95k - $110kGainwell Technologies
Florida, NY
- Remote job
Gainwell Technologies is seeking a DRG Nurse Reviewer Appeals and Hearings professional for remote work. You will coordinate and perform appeal duties, analyze documentation, prepare case files and participate in hearings, both virtual and on-site as needed. Required are an active US RN license, CPC/CCS/CPMA certification, and 5+ years of clinical or coding experience. Expect remote work with up to 25% travel for onsite hearings and a salary range of $95,000-$110,000. #J-18808-Ljbffr Gainwell Technologies
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote DRG Nurse Reviewer & Appeals Specialist in Florida, NY vacancy
$95k - $110k
Select how often (in days) to receive an alert: DRG Nurse Reviewer Appeals and Hearings- Remote Date: Aug 30, 2026 Location: Any city, FL, US, 99999... ...Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA...Remote jobFull timeWork from homeRelocation packageFlexible hours- ...Managing and processing appeals efficiently, the Appeals Specialist II will work in a flexible environment with both remote and on-site options, reviewing case documentation and communicating with clients to resolve issues. Key responsibilities Manage and process appeals...Remote workFlexible hours
Virtual Vocations Inc
United States2 days ago - ...Managing the resolution process for medical and pharmacy member appeals and grievances, the full-time remote Appeals and Grievance Specialist will ensure compliance with regulatory requirements and accreditation standards while coordinating with internal and external stakeholders...Remote workFull time
Virtual Vocations Inc
United States1 day ago $60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances... ...regulatory requirements. This position reviews pre-service authorizations,... ...hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in...Remote workFull timeLocal areaShift workWeekend workL.A. Care Health Plan
Los Angeles, CA5 days ago$22.74 - $27.79 per hour
...Appeals Specialist Remote (WFH) At Adaptive, we're Powering the Age of Immune Medicine. Our goal is to harness the power of the adaptive immune... ...and Essential Functions Appeal Submission Review denied claims and determine appropriate appeal strategy based...Remote workHourly payWork at officeWork from homeHome officeNight shiftAdaptive Biotech
United States4 days ago- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
- ...Working remotely in a full-time capacity, the Appeals Specialist will perform moderately complex appeals work, including researching inquiries and responding to providers and beneficiaries while managing phone discussions and documentation processes. Key responsibilities...Remote workFull timeFor contractorsWork at office
Virtual Vocations Inc
United States1 day ago - ...assigned levels of denials by submitting appeal letters and required documentation to insurance... ...filing time limits. Submit external review requests and required documentation to... ...the patient to get the denial overturned. Remote: Although this position is listed as remote...Remote work
Quadax
Middleburg Heights, OH1 day ago $16 - $18.45 per hour
...Position: Appeals Specialist Location: Remote, US Salary: $16.00-18.45 hourly Overview J29, Inc. (J29) has been supporting commercial, State... ...team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits...Remote workHourly payFull timePart timeFor contractorsWork at officeJ29 Inc.
Eastern, KY2 days ago$21.16 - $38.37 per hour
...Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours. Highly... ...appeals and grievance outcomes. Requests and reviews medical records, notes, and/or detailed...Remote workHourly payFull timeContract workWork experience placementWork at officeMolina Healthcare
Phoenix, AZ18 hours ago- ...healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and... ...case resolutions. This is a 100% remote role requiring an RN, LPN, or... ...practice and knowledge of Utilization Review Guidelines. The position offers a competitive...Remote work
Healthfirst
New York, NY2 days ago - Elevance Health in California is seeking an entry-level Analyst in the Enterprise Grievance & Appeals Department to review, analyze and process non-complex grievances and appeals across multiple product types, including HMO, PPO, POS, and others. You will work under guidance...Remote job
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote jobHourly payWork at office- Aspirion in Delray Beach, FL is seeking a Denials Appeals Specialist to analyze denial reasons, draft persuasive appeal letters, and submit appeals to insurance carriers. Your work will support cash flow, reduce aging, and minimize revenue leakage through timely, high-...Remote job
- UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with...Remote job
$23 per hour
TEKsystems is seeking a Contract Grievances and Appeals Specialist for a fully remote role based out of Columbus, OH. The position analyzes and resolves verbal and written claims and appeals from providers and members, and prepares response letters. This is a contract position...Remote jobHourly payContract work$46.37k - $60.86k
...Job Description Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is the first health... ...into our CGA Team Lead. Work Location: This is a remote position, open to candidates who reside in: Arizona,...Remote workFull timeWork at officeOscar Health
Dallas, TX10 days ago- ...VitalConnect, Inc. is seeking a Denial Management Specialist on a fully remote basis to join the Revenue Cycle team. You will investigate complex third-party insurance denials and optimize reimbursement by researching and acting quickly on denials. The role requires 3...Remote work
VitalConnect
California, MO1 day ago - ...highly skilled subject matter specialists and operations executives, in... ...first and second level appeals of all denials in effort to overturn... ...Terminology, ICD-10, CPT and DRG knowledge Intermediate... ...Conditions: Work from home and remote location with a stable...Remote workWork experience placementWork at officeLocal areaWork from home
Ovation Healthcare
Goshen, IN6 hours ago - ...Inpatient/Outpatient Medical Coding Specialist Front-End Coding | Coding... ...is responsible for reviewing medical documentation and assigning... ...coding-related denials and appeals. · Experience resolving front... ..., Cerner). · Knowledge of DRG, APC, NCCI edits, and medical...Remote workWork at officeLocal area
First Source LLC
Louisville, KY2 days ago $88.79k - $133.18k
...Please note: Remote for Washington State Only Research and analyze... ...on facility payment models (DRG, APC, EAPG) and technical... ...Credentials Certified Coding Specialist (CCS) certification by the... ...coding denial management and appeals process. Experience in research...Remote workFull timeWork experience placementSeattle Children's
United States2 days ago$64.81k - $85.5k
...have the ability to work remotely. DESCRIPTION UC... .... The Credit Refund Specialist is responsible for researching... ...when appropriate. Review insurance refund... ...submission of hospital claims appeals and basic knowledge in... ..., case rate and DRG's. PREFERRED QUALIFICATIONS...Remote workHourly payDaily paidContract workUC San Diego
United States6 hours ago- ...Job Summary: The Revenue Specialist will demonstrate behavior... ...follow-up actions, including appealing denied claims with appropriate... ...revenue cycle functions. Review accounts pre-service for adherence... ...knowledge of CPT, ICD & DRG coding systems. Physical...Remote workFull timeWork at office
Physician Care Coordination Consultants
United States5 days ago $50 - $60 per hour
...Job Description Hospital Appeal UR Nurse Location: Morristown, NJ... ...Hybrid - 4 days onsite / 1 day remote; Potential future schedule of... ...appeals initiative. This role will review denied or underpaid claims,... .... Understanding of DRG/APR-DRG reimbursement . Familiarity...Remote workContract workLocal areaMonday to FridayMedix
Morris County, NJ3 days ago- ...Description Provide timely review and determination of... ...prior authorization, appeals, and/or any other type... ...) or Certified Coding Specialist (CCS) certification through... ...as a Registered Nurse (RN),as required by contract... ...this position Remote but need to be local to...Remote workContract workFor contractorsWork experience placementWork at officeLocal area
Federal Hearings And Appeals
Wilkes Barre, PA24 days ago - ...straight to better care.? Requirements The Nurse Reviewer performs complex medical record reviews... ...Preferred Qualifications MAC or RAC appeals review experience CPC (or similar) coding... ...perform the essential functions. This is a remote position. While performing the duties of...Remote workContract workFor contractorsLocal area
- ...Description Job Description Appeals Specialist (LPN, RN, or Therapist)... ...RegalCare Facility network / Hybrid-Remote options available)... ...In this vital role, you will review clinical denials, construct... ...Partner with facility Director of Nursing, MDS Coordinators, and...Remote workFull time
$32 - $35 per hour
...Description The Reimbursement Specialist II ensures that healthcare... ...information relative to appeals, payor specific billing policies... ...physicians, hospital leaders, nursing staff, patients, and family members... ...Requirements: As a remote-forward organization, this position...Remote workWork at officeLocal area$22.99 per hour
...the phone all day? We are seeking dedicated Appeals Specialists to join a high-performing Utilization Management team! In this 100% remote role, you will act as the first line of... ...Working from the comfort of your home, you will review reconsiderations, analyze medical...Remote workHourly payPermanent employmentTemporary workWork experience placementHome officeShift work$22.99 per hour
We are hiring for Appeals Specialists with our Heathcare client! These positions are 100% remote TX based. Please inquire if other positions are available if you reside... ...equipment is provided The Appeal Specialist II reviews claims to determine authorization...Remote workHourly payPermanent employmentTemporary workWork experience placementShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote DRG Nurse Reviewer & Appeals Specialist. Be the first to apply!
Related searches
- clinical nurse specialist Florida, NY
- associate degree nursing Florida, NY
- physician consultant remote Florida, NY
- remote insurance agent Florida, NY
- remote customer service advisor Florida, NY
- medicare sales agent remote Florida, NY
- remote insurance Florida, NY
- localization project manager remote Florida, NY
- remote clerk Florida, NY
- remote from anywhere Florida, NY