Remote RN Medical Claims Reviewer
Broadway Ventures LLC
- Remote job
A leading healthcare consulting firm is seeking a dedicated Registered Nurse (RN) to join the Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with clinical guidelines. The successful candidate will have an active RN license and two years of clinical experience. Strong analytical and communication skills are essential. This position offers a remote work environment with all necessary equipment provided. #J-18808-Ljbffr Broadway Ventures LLC
- ...Carolina is looking for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing complex claims... ...clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical experience...Remote workClaimsFull time
$40 per hour
...quality organization is seeking a Nurse Reviewer to support Medical Review Services. The role involves conducting... ...medical necessity reviews for Medicaid claims in a remote work setting. Candidates should have a BSN with active RN licensure and at least three to five...Remote workClaimsHourly payPart time- ...Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business...Remote workClaimsFull timeFor contractorsWork at officeHome officeMonday to Friday
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review... ...monitor medical necessity using your clinical proficiency and claims knowledge. This is a REMOTE opportunity for candidates...Remote workClaimsFull timeContract workLocal areaShift work
$36 - $48 per hour
Santa Barbara Cottage Hospital is seeking a Medical Claims Clinical Review Nurse for a remote position. This role involves conducting clinical reviews of medical... ...with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote jobClaimsHourly pay- MedPOINT Management is seeking a Medical Claims Clinical Review Nurse to ensure the accuracy and quality of medical claims from a remote location. The ideal candidate holds a valid RN license in California and has at least 3 years of nursing experience. Responsibilities...Remote jobClaims
- ...University of Minnesota School of Nursing is seeking a Clinical Claim Review Nurse who will perform claim reviews to verify coding and... ...U.S. Candidates must hold an associate's degree and an active RN license, with a minimum of 2 years of clinical experience. The...Remote jobClaims
- Texas Health Institute is hiring a Clinical Claim Review Nurse to perform claim reviews, ensuring... ...an Associate's degree, an active RN license, and at least 2 years of clinical... ...experience. Bountiful benefits, including PTO, medical plans, and 401(k), are offered to support...Remote jobClaims
- Stryker Corporation is seeking a Clinical Claim Review Nurse to perform detailed reviews of claims against medical records. The position offers the flexibility to telecommute... ...possess an Associate's degree and an active RN license. Responsibilities include ensuring...Remote jobClaims
- ...weeks for training, then will be fully remote. Must be willing to come onsite occasionally... ...- 23/hr Description - ~Performs medical reviews using established criteria sets and/or... ...Provides support and review of medical claims and utilization practices. ~ May provide...Remote jobClaimsFor contractorsLive in
- Optum is seeking a Clinical Claim Review Nurse to perform claim reviews and ensure compliance in a telecommute role. You will verify coding... ...necessary resources. This role requires an Associate's degree, active RN license, and clinical experience. You’ll enjoy comprehensive...Remote jobClaimsFlexible hours
- Optum is looking for a Clinical Claim Review Nurse to perform claim... ...federal policies. This fully remote position allows you to contribute... ...benefits including paid time off, medical plans, and a 401(k) savings... ...'s degree, an active RN license, and at least 2 years...Remote jobClaims
- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is... ...vaccine- and countermeasure-related injury claims. These programs provide compensation... ...OR advanced degree (e.g., NP, PA, RN). At least 3 years of experience conducting...Remote workClaimsHourly payContract work
- ...As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided...Remote workClaimsExtra income
$19 per hour
...Job Description NOW HIRING: Medical Claims Reviewer Location: Harrisburg, PA (Hybrid - 2 Days Onsite / 3 Days Remote) Pay Rate: $19.00/hour Schedule: Monday - Friday, 8:00 AM - 4:00 PM Overview A-Line Staffing is seeking a detail-oriented...Remote workClaimsWork at officeImmediate startMonday to Friday2 days per week- ...Summary Performs medical reviews using clinical/medical information... ...support and review of medical claims and utilization practices.... ...onsite training and five weeks of remote training. One week of onsite... ...Need: License: Active RN licensure in state hired, OR,...Remote workClaimsFull timeFor contractorsWork experience placementLive inWork at officeLocal areaWork from homeHome officeMonday to FridayShift work
- A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing reports, and consulting with medical experts. Candidates must hold an MD/DO or relevant...Remote jobClaimsContract work
- Itemized Bill and Medical Record Reviewer job at Alaffia Health. New York, NY. About... ...have experience reviewing claim forms and auditing provider... ...Clinical license required (RN) preferred Experience working... ...access to Leadership LI-REMOTE #J-18808-Ljbffr Alaffia HealthRemote workClaimsFlexible hours
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and...Remote workClaimsFull time
$47.06k - $70.24k
...solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting findings, and communicating with claims examiners. Candidates must have a current RN license and at least four years of...Remote workClaims$67.7k
...re your trusted partner in innovation. Medical Claims Reviewer Overall Purpose of the Position:... ...and Certificates : Active, unrestricted RN licensure from the United States and in... ...Monday to Friday Work Location: remote within three hour driving radius of Augusta...Remote workClaimsFull timeContract workFor contractorsLive inWork at officeWork from homeHome officeMonday to FridayFlexible hoursShift work- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in... ...involves reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...enjoying the flexibility of a primarily remote work environment. If you are passionate...Remote workClaims
- ...outcomes. Our talented remote workforce spans the... ...benefits that include: Medical, dental and vision... ...Role: Lead Clinical Reviewer DC Medicaid Contract... ...of medical records and claims. The role requires collaboration... ...field. Active RN licensure. Minimum...Remote workClaimsContract work
- ...Integrated Nurse Case Manager/RN/Maternity/OBGYN for Virginia Beach... ...face-to-face assessments and remote telephonic assessments for the... ...Interfaces with Medical Directors, Physician Advisors... ...problem solving with provider, claims or service issues. Education...Remote workClaimsPermanent employmentFull timeTemporary workShift work
- ...intelligence company is seeking a Nurse Itemized Bill Reviewer to analyze medical claims and ensure compliance with industry standards. This remote position allows candidates to work from... ...candidates should possess an active RN, LPN, or LVN license, along with at least 1...Remote workClaims
$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals) Experience: Open... ...*** Location: Remote (can sit anywhere in the US as... ...benefits review, supporting Medical Review Analysts, and Physician... ...project expands. 4. Claims assessment and adjudication....Remote workClaimsLocal areaImmediate startFlexible hours$35 per hour
...Description Telephonic Nurse Case Manager (1099 Remote - NJ RN License Required) We are currently... ...plans with providers, employers, and claims adjusters Monitor patient progress and facilitate appropriate medical care Maintain timely and accurate documentation...Remote workClaimsContract workLocal areaFlexible hours- Stryker Corporation is looking for a Clinical Claims Review RN to perform reviews of inpatient hospital claims. This role supports a high-volume environment and allows for telecommuting from anywhere in the U.S. The ideal candidate must have an RN license, a minimum of...Remote jobClaims
- ...Description Description: The Medical Nurse Reviewer applies clinical nursing expertise to review claims, medical records, and provider... ...Registered Nurse (RN) license in state of residence... ...Location and Environment 100% Remote PHI/PII Requirement: Yes. The...Remote workClaimsFull timeWork at officeFlexible hours
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Claims Review RN to perform administrative reviews of short-stay inpatient hospital claims. This role supports a production-driven environment and allows telecommuting from anywhere in the U.S. The ideal candidate must have an associate...Remote jobClaimsHourly pay
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