Remote Forensic Review RN - Clinical Billing Expert
Stryker Orthopaedics
- Remote job
Stryker Corporation is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews. This role involves analyzing hospital bills, conducting forensic reviews, and maintaining compliance with HIPAA standards while working independently within a framework of policies. The ideal candidate should possess strong clinical knowledge, analytical skills, and a comprehensive understanding of billing guidelines. A competitive hourly wage and comprehensive benefits package are provided. #J-18808-Ljbffr Stryker Corporation
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Review Clinician to perform Forensic Reviews on hospital bills, assisting with claims resolution and departmental goals. The role requires strong clinical knowledge and the ability to analyze charge details comprehensively. Benefits...SuggestedHourly pay- ...Barbara Cottage Hospital is seeking a clinical professional for a fully remote role focused on medical management.... ...requires an active New York State RN licensure and involves analyzing authorization... ...providers, conduct clinical reviews, and ensure that members receive the...Remote jobFlexible hours
$50 per hour
...A leading healthcare staffing firm is seeking an experienced RN Clinical Reviewer to work remotely. You'll conduct detailed medical-legal reviews and appeals while maintaining high accuracy and integrity. Key qualifications include a New York State RN license and at least...Remote work- ...role, you'll use your clinical knowledge outside ofthe... ...traditional bedside setting to review and audit claims,... ..., documentation, and billing data Collaborate with... ...unrestricted Registered Nurse (RN) license Strong... ...populations Remote work - enjoy the convenience...Remote workFull timeTemporary workWork at officeWork from home
- ...role, you'll use your clinical knowledge outside ofthe... ...traditional bedside setting to review and audit claims,... ..., documentation, and billing data Collaborate with interdisciplinary... ...Registered Nurse (RN) license Strong... ...vulnerable populations Remote work - enjoy the...Remote workFull timeTemporary workWork at office
$60 - $85 per hour
...education technology firm is seeking an experienced registered nurse for a remote Expert Question Reviewer role in NCLEX-RN exam preparation. You will evaluate practice questions for clinical accuracy and alignment with NCSBN standards. The ideal candidate will have over...Remote workHourly payContract workFlexible hours$90.87 - $154.33 per hour
Prime Therapeutics is seeking a Physician Clinical Reviewer for Rheumatology to join their remote utilization management team. In this role, you will review service requests, collaborate with physicians, and ensure adherence to clinical guidelines. Candidates must have...Remote workHourly pay$150 per hour
...About the job Remote | Physician Clinical Review Expert - $150-$220/hour We are sharing a specialised part-time consulting opportunity for physicians experienced in clinical diagnosis, treatment planning, patient care management, medical documentation, clinical...Remote workHourly payWeekly payContract workPart timeFor contractorsFlexible hours$28.94 - $51.83 per hour
...Connecting. Growing together. The Clinical Review Clinician serves as a subject matter expert for itemized bill reviews and analyzing hospital... ...to the preparation of Forensic Reviews for specific clients.... ...higher) Active and unrestricted RN license OR LPN in the state of...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$35 - $63 per hour
...Territorial Epidemiologists is hiring a Senior Clinical Appeals RN. This position utilizes expertise in MS-DRG and APR-DRG auditing to review appeals and is responsible for analyzing... ...in ICD-10 coding. The role allows for remote work, and candidates should be solution-oriented...Remote jobHourly pay$35 - $63 per hour
...University of Minnesota School of Nursing is looking for a Senior Clinical Appeals RN. This role involves reviewing and responding to appeals in MS-DRG and APR-DRG auditing and provides coaching to remote specialists. Remote work is available within the U.S., but...Remote jobHourly payWork at office$35 - $63 per hour
Texas Health Institute is looking for a Senior Clinical Appeals RN to utilize expertise in MS‑DRG and APR‑DRG auditing. This role involves reviewing medical records and responding to appeals while providing coaching to remote DRG Validation Specialists. The position...Remote jobHourly payWork at office$70k - $80k
...analytics and solutions company is seeking a Clinical Validation Auditor to ensure accuracy in medical claims coding. This fully remote position requires a Registered Nurse with... ...care experience. Responsibilities include reviewing medical records, documenting findings, and...Remote job- ...intelligence company located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring compliance with... ...assurance guidelines. This role requires an active RN license and the ability to analyze claims data and regulations...Remote job
- ...A healthcare organization is seeking a Clinical Services Specialist RN to perform reviews of patient records for medical necessity compliance. This full-time role involves analyzing records according to policies and facilitating communication with various stakeholders...Remote workFull timeWork from home
$60 - $85 per hour
...join our content quality team as an Expert Question Reviewer for NCLEX-RN exam preparation materials. You'll review... ...Health, and Pharmacology — ensuring clinical accuracy, appropriate difficulty,... ...is a contract position — flexible, remote, and project-based. You'll work...Remote workHourly payContract workFlexible hours- ...discretion and completely remote. We require at least 5... ...be responsible for reviewing pertinent patient data,... ...received for accuracy of clinical and demographic information... ..., LPN Reviewers and RN Reviewers in building... ...care plan sign off and billing. Identify discrepancies...Remote workFor contractors
- ...healthcare consulting firm is expanding its team by hiring a Clinical Appeals Review Nurse. This role involves completing clinical denial reviews... ...on charge documentation. Required qualifications include an RN certification, experience with DRG denials, and preferred...
- ...Concierge Home Care in Jacksonville, FL is seeking an experienced Utilization Review Specialist (RN) to join its remote home health team. The ideal candidate should have strong expertise in OASIS, coding, QA, and home health documentation review. This role offers flexibility...Remote work
$28.94 per hour
Texas Health Institute is seeking a Clinical Review Clinician to conduct forensic reviews and analyze hospital facility bills as part of a specialized team. This role requires a thorough understanding of claim review processes, clinical records, and billing guidelines....Hourly pay$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused... ...losses due to errant billing practices. We are the premier... ...Commercial Payers. You will work remotely in a fast paced and dynamic... ...Active unrestricted RN license in good standing, is...Remote workFor contractorsWork at officeWork from homeHome officeShift work- COMAGINE HEALTH is seeking a registered nurse for Clinical Review and QIDP responsibilities, working remotely from any U.S. location. The role requires an active RN license in Alabama, a BA/BS in Nursing, and at least three years of direct patient care experience. Responsibilities...Remote workWork from home
- ...A health organization is seeking a Registered Nurse (RN) to perform clinical review and QIDP work remotely. The ideal candidate will assess medical necessity according to Alabama Medicaid guidelines and possess a current RN license in Alabama, along with a BA/BS in Nursing...Remote work
- A leading staffing firm is seeking a Clinical Care Reviewer to conduct thorough medical necessity reviews under the supervision of a unit supervisor. The role requires a Registered Nurse with at least 3 years of experience in a clinical setting, focusing on ensuring that...
- ...Centene Corp. is looking for a Clinical Review Nurse - Prior Authorization to work remotely. This position entails analyzing prior authorization requests to determine... .... Applicants must have an active New York State RN licensure and a degree from an Accredited School of...Remote workMonday to Friday
- ...Registered Nurse with active licensure and minimum 3 years of clinical experience for a remote position. Candidates must have strong clinical... ...eligible for DoD background clearance. This role involves reviewing medical records, identifying quality issues, and...Remote work
- ...Job Title: NC - RN Clinical Research Coordinator - Asheville... ...eligibility independently. Review draft informed consent documents... ...ensure compliance with research billing practices. Critical... ...Friday 8:00 AM - 5:00 PM. Remote work possible as required....Remote workFull timeMonday to Friday
$85k - $92k
...TEEMA Solutions Group is seeking a Clinical Quality Reviewer to support a federal healthcare program. This... .... Candidates must have a valid RN or LCSW license with at least three years... ...clinical experience. The position may be remote or onsite based on business requirements...Remote workWork at officeHome office- ...COMAGINE HEALTH in Nevada seeks a Supervisor, Clinical Review to supervise clinical staff conducting... .... Ideal candidates will have an active RN licensure in Alabama, with 3+ years of... ...are crucial. The position offers a remote work option along with comprehensive benefits...Remote work
$59.5k - $116.6k
UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring... ...requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate will work primarily during...Remote jobWeekend work
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