Remote RN Billing & Care Review Specialist
Partner Engineering and Science
Partner Company is seeking an experienced registered nurse to support medical billing review and utilization reviews. You will review medical records and itemized bills to ensure billing accuracy and appropriate care, applying clinical judgment to assess medical necessity. The role is remote, with flexible PTO, health benefits, a 401(k) plan, and education assistance. Requires 5+ years inpatient nursing experience and coding knowledge (CPT/ICD-10/HCPCS). #J-18808-Ljbffr
$63.1k - $94.65k
...Must have current compact RN license, or be willing... ...Information: Our Utilization Review team provides coverage... ...utilization of health care resources and assists... ...office regarding billing issues related to third... ...Required: This is a remote role which requires access...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$70k - $95k
...We are seeking a remote Clinical Claims Review RN to join an established and growing clinical review team.... ...In this role, you will combine acute care clinical judgment with hands on review... ...charge, supply, implant, and medication billed is ordered, documented, and supported...Remote workHourly payFull timeWork at officeLocal areaMonday to Friday$29 - $52 per hour
...Clinical Review ClinicianOptum is a global organization that delivers care, aided by technology, to help millions of people live... ...subject matter expert for itemized bill reviews and analyzing hospital... ...s degreeActive and unrestricted RN license OR LPN in the state of residence...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$29 - $52 per hour
...Optum Clinical Claim Review NurseOptum is a global organization that delivers care, aided by technology, to help millions of... ...applicable processes, procedures and billing guidelines.You will enjoy the... ...s degreeActive and unrestricted RN license in the state of residence...Remote workHourly payMinimum wageFull timeContract workTemporary workWork experience placementWork at officeLocal area$29 - $52 per hour
...drive alignment between care providers and payers,... ...performing compliance reviews of medical and administrative... ....This position is Remote in Massachusetts. You will... ...licensure (RN or LPN) with a current,... ...information, and healthcare billing practicesExperience working...Remote workHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- ...Utilization Management RN Reviewer Location Cleveland Facility Remote Location Department Utilization... ...Management (UM) Specialists perform UM activities, such... ...Office Knowledge of billing practices, identification... ...Knowledge and experience with Care Guidelines, Medical...Remote workFull timeWork at officeShift workWeekend work
$78k - $85k
Overview Medicaid Medical Review RN (Medical Reviewer III) - REMOTE The Medicaid Medical Review RN (Medical Reviewer... ...files) to determine provider billing patterns and to detect potentially... ...a state Medicaid agency or Managed Care Organization focused in Medicaid 2...Remote workFor contractorsH1bH2bWork at officeLocal areaHome office- ...Molina Healthcare is seeking a Care Review Processor I to join the CAM team. The role supports members requiring hospitalization or utilization... ...information to healthcare staff. The position is fully remote with a schedule during training (8–5 p.m. EST) and post-...Remote work
- ...professionals specializing in child and youth abuse to contribute to a remote project focused on improving AI systems' understanding of trauma-informed care and mental health support for vulnerable youth. You'll review and improve AI-generated content related to abuse, trauma,...Remote work
- ...Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The role of Clinical Review Clinician focuses on itemized bill reviews and analyzing hospital facility bills, documenting, researching and identifying...Remote work
- ...seeking an Utilization Review Registered Nurse (Post-service... ...Medical Review 3) for remote work in California. The... ...-line audit of hospital bills to ensure contract... ...billing practices. Strong RN credentials in California... ...have 5+ years in managed care, experience with inpatient...Remote workContract work
$7.5 per hour
...RN – Critical Care Transport, ECMO Specialist & CVICUWe invite you to join Scripps Memorial La Jolla, a nationally... ...Transfers to other locations will be reviewed on a case-by-case basis and may... ...pay differential may be applied for remote employees who reside out of state....Remote workFull timeRelocation packageShift workNight shift- ...Community Hospital located in Missouri seeks a Utilization Review Coordinator (RN) to support a comprehensive review system, ensure regulatory... ...compliance, promote efficient resource use, and enhance patient care. The role requires 2+ years of nursing experience, MO RN...
$78k - $99.2k
...Review medical records and itemized bills to ensure billing accuracy and appropriate care. Apply clinical judgment to assess medical necessity and... ...compliance. Requirements: Active RN license and 5+ years... ...1(k), education assistance, remote work. Partner Company Our partner...Remote workFlexible hours$78k - $99.2k
...individual for a Senior Nurse Reviewer to perform reviews of medical records... ...claims, itemized medical bill, and UB-04 forms to ensure accuracy... ...standards. Perform level of care and utilization review by analyzing... ...required CEUs to maintain RN license. Responsible for attending...Remote workFull timeWork from homeFlexible hours- ...Berkshire Hathaway Homestate Companies is seeking a Medical Bill Specialist for its Medical Bill Review team in Omaha, NE. The role involves processing and reviewing medical bills and verifying documentation before review by a Medical Bill Analyst. Responsibilities...Remote work
$45k - $55k
...they're met with barriers to care. From limited local options... ...as a Care Experience Specialist. This candidate will welcome... ...teams such as, Admissions, Billing, Utilization Review, Outreach and Clinical Support... ...-sponsored benefits. #LI-Remote Based on the nature of...Remote workFull timeTemporary workWork at officeLocal area- ...Paramus, NJ. You will perform concurrent utilization review, ensure medical necessity, and support admission... ...while coordinating with physicians, payers, and care teams. Requirements include BSN and an active NJ RN license; prior case management or utilization review...Hourly pay
$50.89 - $76.33 per hour
...RN Wound Care SpecialistPeaceHealth is seeking a RN Wound Care Specialist for a Per Diem/Relief, Day position.The salary range for this... ...program. Assists in review of Pressure Ulcer Policy and Procedure... ...pertain to scheduling, treatment, billing and infection control.Performs...Daily paidWork experience placementLocal area- ...your profile Please respond with your updated profile if interested Title: Clinical Care Reviewer Location : Doral, FL Duration : 3 months Job Related Skills and Experience: • Current FL RN licensure • Registered Nurse graduated from an accredited Diploma, Associates...
- ...apply for the Medical Claim Review Nurse role at Integrated... ...Claims Review Nurse (RN) is responsible for... ...regulatory, coding, and billing guidelines. Nurses in this... ...reimbursement and quality care outcomes. Key Responsibilities... ...0a-4p Mon-Fri/no wknds (REMOTE) Lake Mary, FL $72,000.0...Remote workFull timeLocal areaShift work
$53.19k - $82.43k
...providing the highest-quality medical care in Los Angeles. We were also... ...payor contracts and CSMC billing and collections policy and... ...A/R per department protocol. Reviews accounts on continuing basis and... ...available resources. *Approved Remote States: Arizona, California,...Remote workFull time- Elaya Health is seeking a Remote Registered Nurse (RN) for full-time or part-time positions in Principal Care Management (PCM). This role involves reviewing patient charts, coordinating care, and ensuring compliance with CMS guidelines. The ideal candidate will hold an...Remote jobFull timePart timeFlexible hours
$63.9k - $83.08k
...Claims Review Nurse, LVNFind joy in serving others with IEHP! We welcome you to join us... ...the Supervisor, Integrated Transitional Care, the Claims Review Nurse, LVN is responsible... ...care on in-patient reviews. Track trends in billing patterns by provider and report to...Remote workTemporary work$61.05k - $98.33k
...Itemization Review Nurse The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges... ...submitted by a medical facility to determine accuracy of billed charges. This is a remote position. Essential Functions & Responsibilities:...Remote workFull timeWork at officeFlexible hours- ...client is seeking an experienced Workers’ Compensation Medical Bill Review Specialist to join their California team on a temporary basis. This... ...Benefits while on assignment ~ Opportunity to transition to permanent employee ~ Flex schedule and ability to work remotely...Remote workPermanent employmentTemporary workFlexible hours
- ...PruittHealth is seeking a PRN Registered Nurse (RN) ICD-10 and Oasis Reviewer to join PruittHealth @Home. The role... ...and ICD-10 certification, with remote home health work available in GA/SC/NC... ...patients where they reside, applying care plans and Oasis reviews to ensure high...Remote workReliefWork from home
- ...It is expected that all RN Clinical Nurses are... ...administrative compliance. Unlike remote roles, this position... ...the current level of care.o Medical Provider... ...Complianceo Medical Necessity Reviews: Use criteria like... ...order for patient type for billing, appropriate billing).*...Remote workFull timeImmediate startShift work
$50k - $60k
...Technologies is seeking a Medical Reviewer (Laboratory Specialist) to provide laboratory... ...of requested or billed laboratory services. Support... ...Full-time position. Remote work environment. Monday... ...bring together people who care deeply about making healthcare...Remote workFull timeHome officeMonday to FridayFlexible hours- Transcarent is hiring a Remote Care Operations Specialist to support day-to-day execution of care programs. You will analyze cases, review cost shares, and support savings workflows while... ...communication skills to work with clinical, billing, and client teams in a fast-paced...Remote job
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