Remote RN: Clinical Review & Billing Auditor
ISHE
- Remote job
UnitedHealth Group seeks a Clinical Review Clinician to analyze itemized hospital bills and document adjustments for forensic reviews. Telecommute from anywhere in the U.S. The role requires clinical experience, RN or LPN license, and bill review knowledge. You will support claims through research and QA until client-ready. Join a team with comprehensive benefits, ongoing development, and a commitment to health equity and quality care. #J-18808-Ljbffr ISHE
$68.57k - $104.84k
...a DRG Quality Control/Clinical Auditor. The Diagnostic Related... ...(clinical/coding) reviews of medical records and... ...necessity rules. This is a remote position. ESSENTIAL... ...determine accuracy of billing through verification... ...: LVN or RN license in the state of...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative... ..., and collaboration with a team of auditors to document findings and input data... ...is full-time (40 hours/week) with remote work options in Massachusetts and potential...Remote jobFull timeLocal area
- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching... ...and maximize client savings by reviewing medical bills from a nurse perspective... ..., appropriate and necessary. Clinically identify and evaluate any charges...Remote workImmediate start
- UnitedHealth Group's Optum is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and hospital facility bill analyses. You will... ...and requires an associate degree, active RN or LPN license, and 2+ years of clinical experience...Remote job
- Optum is hiring a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and hospital facility bill analysis. The role involves documenting... ..., and supporting negotiations and appeals. Remote work is available nationwide with full benefits...Remote job
- Optum, a part of UnitedHealth Group, is seeking a Clinical Review Clinician to analyze hospital facility bills and document adjustments as part of forensic reviews... ...telecommute flexibility within the U.S. and requires RN or LPN licensure and clinical experience. You will...Remote job
- Optum is seeking a Clinical Review Clinician to act as a subject matter expert for itemized bill reviews and hospital facility bills. This role involves documenting, researching, and identifying adjustments for payment as part of a team preparing Forensic Reviews for specific...Remote job
$29 - $52 per hour
...Clinical Review Clinician Optum is a global organization that delivers care, aided by technology... ...as a subject matter expert for itemized bill reviews and analyzing hospital facility bills... ...'s degree ~ Active and unrestricted RN license OR LPN in the state of residence...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal area- UnitedHealth Group is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and hospital facility bill analysis. You will document, research, and identify adjustments for payments as part of a team preparing Forensic Reviews for...Remote job
$70.14k - $107.25k
...Related Groups (DRG) Clinical Auditor will be responsible for... ...validation (clinical/coding) reviews of medical records and... ...determine accuracy of billing through verification... ...EXPERIENCE: LVN or RN license in the state... ...with ADA regulations as applicable. #LI-Remote...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours$29 - $52 per hour
...Program Integrity Clinical Compliance Auditor Optum Insight is improving... ...compliance reviews of medical and administrative... ...This position is Remote in Massachusetts. You... ...~ Nurse licensure (RN or LPN) with a current... ...information, and healthcare billing practices...Remote workHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- Optum is hiring a Clinical Review Clinician to act as a subject matter expert for itemized bill reviews and hospital facility bills. The role includes documenting, researching, and identifying adjustments needed for payment as part of a team preparing Forensic Reviews for...Remote job
- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis of hospital facility bills. You will document, research, and identify adjustments as part of a team preparing Forensic Reviews for clients....Remote job
- UnitedHealth Group's Optum is seeking a Clinical Review Clinician to act as a subject matter expert in itemized bill reviews and hospital facility bills. You will document and research adjustments for Forensic Reviews for specific clients. This role offers telecommuting...Remote job
- UnitedHealth Group is seeking a Clinical Review Clinician to perform forensic reviews of hospital facility bills and document adjustments with clinical accuracy. You will analyze charge details, compare to guidelines, and participate in negotiations and appeals within...Remote job
- ...training curricula for clinical audit nurses and audit... ...IPF and IRF claim review, documentation requirements... ...and facility-specific billing rules. Maintain and... ...effective delivery in a remote environment. Training... ...vs. SNF — and train auditors to apply those distinctions...Remote workFull timeWork at office
$80k - $90k
...Job Title: RN Medical Bill Auditor Location: Remote Compensation: $80,000 - $90,000 annually, based on... ...offers the opportunity to leverage clinical nursing expertise in a data-driven... ...OR, ICU, or ER who is comfortable reviewing complex medical charges, analyzing...Remote workFull timeWork experience placementLocal area$78.91k - $98.64k
...Summary Provides clinical and technical... ...compliance with industry billing standards. This is... ...coordinator and/or auditor. # Certified Professional... ...preferred. # RN, LPN or associate’s... ...experience in review of medical records.... ...to support remote or hybrid work. Must...Remote workHourly payFull timeWork at officeWork from homeAfternoon shift- The Clinical Chart Auditor is responsible for conducting systematic reviews of patient medical records to ensure clinical documentation... ...for retina-specific services. Remote work options may be available... ...insights to leadership, billing, and clinical teams for process...Remote workFull timeWork at office
- ...Corporate Compliance Clinical Auditor to join our teams’ mission... ...in our core values! Remote or Hybrid with travel... ...involves conducting facility reviews, identifying... ...assess compliance with billing, coding, documentation... ...Active clinical license (RN, LPN, PT/OT/ST, etc)...Remote workWork experience placementWork at office
$45.67 per hour
Auditor Clinical Validation Outpatient Specialty Clinical Job Locations US-Remote ID 2026-18743 Category Audit - Healthcare Position... ...disciplines from a coding and billing perspective: SNF, IRF, Home... ...audits. with a focus on clinical review, coding accuracy, medical...Remote workHourly payFull timeContract workWork at officeImmediate start- ...Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical documentation. You will review medical records to ensure alignment... ...recovery or referrals. This is a remote role with NYC/Tempe office options....Remote jobWork at office
$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant,... ...losses due to errant billing practices. We are the... ...experienced medical auditors and coders performing... ...Payers. You will work remotely in a fast paced and dynamic... ...Active unrestricted RN license in good...Remote workFor contractorsWork at officeWork from homeHome officeShift work$92.4k - $133.67k
...Supervises a team of auditors that participate in financial... ...initial and subsequent reviews of Primary Care... ...provide safe and effective clinical services. Creates and... .... ~ California RN license in good standing... ...Work Mode: Partially Remote An annual employee bonus...Remote workContract workLocal areaHome office$60 per hour
...discretion and completely remote. We require at least... ...be responsible for reviewing pertinent patient data,... ...received for accuracy of clinical and demographic... ...Reviewers, LPN Reviewers and RN Reviewers in building their... ...care plan sign off and billing. Identify...Remote workHourly payFor contractors- ...Medical Review Nurse - Home Health Auditor Machinify is a leading healthcare intelligence... ...Payers. You will work remotely in a fast-paced and... ...members. Cross train in all clinical departments/areas. Other... ...nursing (active/unrestricted RN license) is required....Remote workWork at office
- ...leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance... ...quality documentation. The role emphasizes strong clinical judgment, coding accuracy, and regulatory awareness...Remote jobWork from home
- DaMar Staffing is seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services... ...analyze claims data, conduct retrospective reviews, review billing practices, prepare reports, and participate in hearings and...Remote job
- Medix is seeking a Clinical Review RN for Prior Authorization, with 2 years of acute care experience and 1 year in prior authorization. The role... ...physicians and analysts to ensure accurate authorizations. Onsite in Jericho or remote in RI is possible. #J-18808-Ljbffr Medix™Remote job
- Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The role is remote, with half-time focus on QIDP reviews and half-time on nurse clinical review. The position requires licensure in Alabama, a BA/BS in Nursing, and at least 3 years of direct...Remote job
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