Remote Medical Review Nurse II - Clinical Validation
Machinify
New York, NY
- Remote job
Machinify is seeking a Medical Review Nurse II to perform medical claims audit reviews for Government and Commercial Payers. This role requires an active RN license and at least 2 years of relevant experience. The position is remote, and you will be part of a dynamic, multi-location team. Key responsibilities include auditing claims, documenting findings, and collaborating with teams to ensure compliance and quality. Preferred qualifications include expertise in ICD-10 coding and utilization management systems. #J-18808-Ljbffr Machinify
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medical Review Nurse II - Clinical Validation in New York, NY vacancy
$69.3k - $78k
A healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and Commercial... ...auditing claims and documenting findings, all in a remote work environment. This role offers a competitive...Remote jobMedical$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled... ...for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part...Remote workMedicalFor contractorsWork at officeWork from homeHome officeShift work- The Rawlings Group is seeking a Remote Medical Review Nurse II to perform medical claims audits. You will join a team assessing government and commercial claims. This role requires an active RN license and offers the chance to work collaboratively in a fast-paced environment...Remote jobMedical
$143.1k - $165.05k
...Nurse Case Manager II P Burlingame, CA 94010 Overview... ...to the clinical team, service lines... ...not provide direct medical care to patients;... ...CC/CM program. Reviews and updates case... ...Qualifications: Valid California... ...in understaffed/remote areas, in the presence...Remote workMedicalFull timeWork at officeNorth East Medical Services
Burlingame, CA1 day ago- ...ForHealth Consulting at UMass Chan Medical School is seeking a Nurse Reviewer II to conduct in-person assessments and determine clinical eligibility for individuals receiving services through the Family Assistance Pathway. The role involves documenting assessments, providing...Medical
ForHealth Consulting at UMass Chan Medical School
Westborough, MA5 days ago $87.74 - $115.7 per hour
...independent advanced level nurse practitioner clinical expertise to... ...chronic stable medical conditions,... ...Qualifications NP I/II: Two (... ...Possession of valid California RN and... ...Yes Hybrid/Remote/Onsite: This position... ...Disclosure review where you will be...Remote workMedicalHourly payContract workTemporary workWork at officeLocal areaFlexible hoursShift workNight shiftUC Davis Health System
Sacramento, CA6 days ago$52k - $83k
...CopperPoint Insurance Companies is offering a fully remote position for a Premium Audit Reviewer II. This role requires reviewing and evaluating premium... ...0.00 and $83,000.00 annually, with benefits including medical, dental, vision, and a 401k plan. #J-18808-Ljbffr...Remote workMedicalCopperPoint Insurance Companies
Raleigh, NC5 days ago$52k - $83k
...Insurance Companies has an exciting opportunity for a fully remote Premium Audit Reviewer II. The role involves reviewing and evaluating premium... .... The salary ranges from $52,000 to $83,000 annually, with benefits including medical, dental, and PTO. #J-18808-Ljbffr...Remote workMedicalCopperPoint Insurance Companies
Nashville, TN5 days ago$52k - $83k
...CopperPoint Insurance Companies is looking for a fully remote Premium Audit Reviewer II. In this role, you'll evaluate premium audits for accuracy... ...to $83,000 annually along with comprehensive benefits including medical, dental, and retirement plans. #J-18808-Ljbffr...Remote workMedicalCopperPoint Insurance Companies
Florida, NY4 days ago$52k - $83k
...CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II in Nebraska. In this role, you will evaluate premium audits for... ...the ability to communicate effectively. Benefits include medical, dental, and a 401k plan, with a salary range of $52,000...Remote workMedicalCopperPoint Insurance Companies
Lincoln, NE5 days ago$52k - $83k
...CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II in Pennsylvania. The role involves reviewing and evaluating premium... ...$83,000.00 annually and comprehensive benefits including medical, dental, vision, 401k, and paid time off. #J-18808-Ljbffr...Remote workMedicalCopperPoint Insurance Companies
New York, NY5 days ago$61.05k - $98.33k
...Itemization Review Nurse II The Itemization Review Nurse provides a summary and analysis of items by... ...reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. Essential functions and...Remote workMedicalFull timeWork at officeFlexible hoursCorVel
United States7 days ago$52k - $83k
...CopperPoint Insurance Companies is seeking a fully remote Premium Audit Reviewer II to evaluate and review premium audits for accuracy and compliance... ...00 annually, as well as comprehensive benefits including medical, dental, and PTO. Join a team that emphasizes customer...Remote workMedicalCopperPoint Insurance Companies
Annapolis, MD4 days ago$27.61 - $41.41 per hour
...and does not offer a hybrid or remote option Summary :... ...maintain sharp safety, ensure medication safety on the surgical field,... ...and cost of living. Market reviews: All UCHealth positions are reviewed... ...decisions based on valid requirements. No applicant shall...Remote workMedicalFull timeTemporary workLocal areaFlexible hoursShift workUCHealth
Aurora, CO10 hours ago- ...A leading consulting firm is seeking a HEDIS Reviewer II for a remote position. The role involves interpreting clinical criteria through medical records, ensuring accurate documentation for compliance with HEDIS and CMS. Candidates must possess a high school diploma or...Remote workMedical
SGS Consulting
New York, NY2 days ago - ...Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service necessity and efficiency, ensuring quality care based on clinical guidelines. The UMRN will work closely with various...Remote workMedicalFlexible hours
Harris Health System
Bellaire, TX4 days ago - ...Overview Clinical Review Nurse - Concurrent Review TX Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday... ...clinical faxed in by facilities for medical necessity. The nurse gains... ...inpatient services to validate the necessity and setting of care...Remote workMedicalContract workShift work
ESR Healthcare
Wausau, WI2 days ago - ...HEDIS Reviewer II job at SGS Consulting. Remote. Job Responsibilities: This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance...Remote workMedical
SGS Consulting
New York, NY3 days ago - ...Job Description The Clinical Registered Nurse (RN) II is responsible for managing individualized... ...health in accordance with medical and nursing plans of care... ...educational workshops; reviews nursing professional... ...be (are) waived for 100% remote employees** Cath Lab/Electrophysiology...Remote workMedicalWork experience placementImmediate startFlexible hours
Centra Health
Lynchburg, VA4 days ago - .... Description The Clinical Research Nurse II will support human physiology... ...and screening, reviewing laboratory results, and maintaining... ...evaluations, administers medications and research instruments and... ...University location. Remote work from home day options...Remote workMedicalWork from home
Emory University
Atlanta, GA4 days ago $26.5 - $47.59 per hour
...Clinical Review Nurse - Concurrent Review Be among the first 25 applicants... ...clinical professional on our Medical Management/Health Services team... ...workplace flexibility. Remote-US position. Must work... ...evaluating inpatient services to validate the necessity and setting of...Remote workMedicalHourly payWork at officeFlexible hoursCentene Corporation
Orlando, FL5 days ago- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote... ...Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting...Remote workMedicalPermanent employmentWork at officeLocal area
American Recruiting and Consulting Group
United States1 day ago $27.02 - $48.55 per hour
...The standard fully remote work schedule is... ...Perform concurrent reviews, including determining... ..., evaluating medical necessity, and contributing... ...services to validate the necessity and... ...based on clinical policies and guidelines... ...accredited school of nursing or a Bachelor’s degree...Remote workMedicalHourly payWork at officeMonday to FridayFlexible hoursCentene Management Company LLC
New York, NY4 days ago$85.98 - $103.68 per hour
...NorthBay Health, a Registered Nurse in the Emergency Department... .... License and Certifications Valid, current, and unencumbered RN... ...comprehensive benefits package including medical, dental, vision, life,... ...market‑based compensation review. Remote Work Disclosure NorthBay...Remote workMedicalHourly payDaily paidShift workNight shiftNorthBay Health
Vacaville, CA1 day ago$85k - $95k
...accountability, and clinical excellence to healthcare... ...including DRG Validation, Cost Outlier and Readmission reviews. We are seeking a registered nurse with experience in clinical... ...within the medical record Must be able... ...applications at the same time Remote Work Requirements...Remote workMedicalFull timeMonday to FridaySanta Barbara Cottage Hospital
New York, NY2 days ago$96.35 - $111.14 per hour
...Category: Nursing Job Type: Full time Shift... ...Benefits Eligible: Yes Remote Eligible: No... ...purpose of the job. The Clinical Nurse II is an RN that practices... ...in the design, review, and evaluation of QI... ...beliefs, marital status, medical condition, genetic information...Remote workMedicalHourly payFull timeShift workNight shiftStanford Medicine Children's Health
Palo Alto, CA2 days ago- ...contractor position. We need a Nurse Practitioner who can... ...and completely remote. We require at least 5... ...will be responsible for reviewing pertinent patient data,... ...received for accuracy of clinical and demographic information... ...of each patients’ medical history, care plan goals...Remote workMedicalFor contractors
Tapestry
New York, NY2 days ago - ...Senior Clinical Nurse II - Virtual Heart Failure Transitional Care Bridge Clinic Join an innovative interdisciplinary... ...clinical assessments, symptom evaluation, medication review, patient education, and ongoing monitoring through remote patient monitoring, virtual platforms and...Remote workMedical
- ...the job details for your review: Job Title: Behavioral... ...Health Case Manager II Job Location- Remote - MI Duration: 4+... ...Through the use of clinical tools and information/data... ...experiencing a behavioral health or medical crisis and refers them to...Remote workMedicalContract workWork at officeShift work
Vir Healthway
Kalamazoo, MI1 day ago - ...Job Description: Clinical Supervisor, UM Denial... ...Type: Hybrid (85% remote, 15% onsite in... ...standards for associated medical groups. Key... ..., performance reviews, and disciplinary... ...accredited Registered Nursing Program; RN preferred... ...environment. 7. Valid CA driver's...Remote workMedicalPermanent employmentTemporary work
Vivo HealthStaff
Burbank, CA9 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Review Nurse II - Clinical Validation. Be the first to apply!
Related searches
- orthopedic nurse practitioner New York, NY
- nurse practitioner New York, NY
- telephonic nurse case manager New York, NY
- dialysis nurse manager New York, NY
- associate director of nursing New York, NY
- administrative director of nursing New York, NY
- trainee nurse practitioner New York, NY
- remote nurse practitioner New York, NY
- nurse practitioner palliative care New York, NY
- nurse practitioner - telehealth New York, NY