Remote DRG Appeals Nurse Denials & Appeals Expert
Kids For The Future
Kids for the Future is seeking a DRG Appeals Review Nurse to analyze and appeal denied MS-DRG and APR-DRG accounts. The ideal candidate will have a Registered Nurse License, relevant coding certifications, and extensive clinical experience. Key responsibilities include reviewing claims for appeal potential, writing detailed appeal letters, and maintaining compliance with regulatory standards. This position offers the opportunity to work from home and includes perks like career support and employee discounts. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote DRG Appeals Nurse Denials & Appeals Expert in New York, NY vacancy
$35 - $63 per hour
Crains Cleveland is looking for a Senior Clinical Appeals RN who utilizes expertise in MS-DRG and APR-DRG auditing to respond to appeals and coach remote DRG Validation Specialists. This role allows for remote work across the U.S., with specific location requirements for...Remote jobHourly pay- UnitedHealth Group is seeking a Senior Clinical Appeals RN to utilize expertise in MS-DRG and APR-DRG auditing to manage appeals. This position allows remote work throughout the U.S., except for... ..., along with a commitment to quality care. #J-18808-Ljbffr Registered NurseRemote jobWork at office
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The 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 Minneapolis...Remote jobHourly payWork at office$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... ...of experience in ICD-10 coding. The role allows for remote work, and candidates should be solution-oriented problem...Remote jobHourly pay$35 - $63 per hour
...Corporation is seeking a Senior Clinical Appeals RN to utilize clinical expertise in appealing... ...records. The role includes analyzing DRG appeals, conducting complex analyses, and... ...years of coding experience with ICD-10. Remote work opportunities are available in the U...Remote jobHourly pay$35 - $63 per hour
Optum is seeking a Senior Clinical Appeals RN to utilize expertise in MS-DRG and APR-DRG auditing for appeals management. This role involves analyzing... ...auditors, and authoring rebuttals. The job can be performed remotely across the U.S., with certain locations requiring in-...Remote jobHourly payWork at office- ...firm is expanding its team by hiring a Clinical Appeals Review Nurse. This role involves completing clinical denial reviews, performing various audit services, and educating... ...include an RN certification, experience with DRG denials, and preferred certifications like CCDS...
- Elevance Health seeks a Nurse Appeals - Licensed Nurse to investigate medical necessity appeals from members and providers. This role allows associates to work virtually full-time, with in-person training sessions as needed. The successful candidate must hold an active...Remote jobFull time
- Elevance Health is seeking a Nurse Appeals - Licensed Nurse to work virtually from Indianapolis, IN, conducting investigations for medical necessity appeals. The role requires a current RN license and a minimum of two years in managed care healthcare. Candidates must have...Remote jobShift work
- Zotec Partners is looking for an AR Specialist to manage claims follow-up in a remote working environment. The position entails identifying billing issues, processing appeals, and resolving correspondence issues. Candidates should have AR follow-up experience, a high school...Remote jobWork at office
$36 - $40 per hour
...Norwood we’re forging our own path. We’re a remote-first staffing and consulting company... ...the healthcare industry. Our team of experts have placed thousands of professionals... ...in your coding career. If you are an Appeals and Denials Nurse looking for a new opportunity to...Remote workPermanent employmentFull timeWork visa- Atlantic Health System in Morristown, NJ, is seeking a Hospital Appeals Specialist (RN) to join their Revenue Cycle Integrity department. The role involves reviewing and appealing medical claims denials, collaborating with physicians, and ensuring compliance with regulations...
- Atlantic Health System is seeking a full-time Hospital Appeals Specialist (RN) in Morristown, NJ. In this role, you will be responsible for reviewing payer denials, developing appeals, and collaborating with healthcare professionals to improve compliance and reimbursement...Full time
- Atlantic Health is seeking a Hospital Appeals Specialist (RN) for a full-time position with shifts from 8 AM to 4 PM in Morristown, NJ. This role focuses on managing payer denials and developing strong appeal letters through collaboration with clinical teams and adherence...Full timeShift work
- Atlantic Health is looking for a Denial Review & Analysis specialist to handle payer denials and appeals. Key responsibilities include reviewing medical records, developing appeals, and collaborating with physicians to improve documentation. The ideal candidate must possess...
- ...Downtown Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform all appeal-related duties, including... ...summaries for hearings. This position is a full-time, permanent remote role that complies with work-from-home policies. The...Remote workPermanent employmentFull timeWork from homeFlexible hours
Downtown Boulder Partnership
El Paso, TX20 hours ago $90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and...Remote workFull timeWork from homeFlexible hoursGainwell Technologies
Florida, NY4 days ago$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 workFlexible hoursGainwell Technologies
Florida, NY4 days ago- ...IMCS Group is seeking an experienced nurse for a 10-month contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with company policies. The position allows for remote work, preferably from Iowa, with possible on-site...Remote workContract work
IMCS Group
West Des Moines, IA4 days ago - Medix™ is seeking a dedicated Appeals Nurse (RN) to join our team in a fully remote capacity. This role involves clinical reviews and appeal determinations while collaborating with Medical Review Analysts and Physician Consultants to ensure compliant outcomes. The ideal...Remote job
- BlueCross BlueShield of South Carolina is hiring an Appeals Analyst to research and analyze complex appeal requests. This full-time position involves conducting thorough clinical reviews to ensure compliance with medical necessity guidelines. The successful candidate will...Remote jobFull timeWork at officeWork from home
$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 workSanta Barbara Cottage Hospital
New York, NY2 days ago- Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree...Remote job
$35 - $63 per hour
...Minnesota is seeking an experienced healthcare coder to analyze DRG Appeals, prepare written appeals, and collaborate with the leadership... ...as well as clinical judgment. Enjoy the flexibility to work remotely from anywhere in the U.S., with specific office requirements for...Remote jobHourly payWork at officeLocal area- ...ability to analyze claims data and regulations effectively. The candidate will be responsible for documentation and reporting within the appeals process, contributing to continuous improvement initiatives in a dynamic healthcare environment. #J-18808-Ljbffr Performant CorpRemote job
- ...Consulting Group Inc. is looking for a Clinical Denials Auditor in Chicago. The successful candidate will manage denials and appeals effectively, ensuring compliance with... ...The role requires a Bachelor of Science in Nursing and significant clinical experience, with an...Remote jobHourly pay
$29.05 - $67.97 per hour
...retrospective, and concurrent review of appeals for denied prior... ...including diagnosis-related group (DRG) validation, itemized bill... ...criteria with medical directors on denial decisions. Supplies criteria... ...At least 2 years clinical nursing experience, including at least...Remote jobHourly payWork experience placementWork at office$90k - $99k
Gainwell Technologies LLC is seeking a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform appeal-related duties, including analyzing... ...including a 401(k) match and health coverage. This is a remote role with up to 25% travel expected. #J-18808-Ljbffr Gainwell...Remote jobFlexible hours$90k - $112.76k
R1 RCM is looking for a Complex Denials Consultant in Detroit, Michigan. In this role, you will represent healthcare providers in disputes with insurance carriers, handling appeals and contract reviews. A law degree and bar eligibility are required. The position offers...Contract work- 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 work
Health Business Solutions
Florida, NY4 days ago
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