Remote Medical Review Nurse | Government Claims Auditor
Machinify, Inc.
Machinify is looking for a Medical Review Nurse to perform medical claims audits for government clients. This remote position requires expertise in coding and a minimum of five years nursing experience. You will work alongside a dedicated team in a dynamic environment, focusing on improving healthcare outcomes. The ideal candidate will possess strong communication skills and must have an active RN license. Relevant experience in claims review and medical coding is essential for this role. #J-18808-Ljbffr
- ...Medical Review Nurse - Home Health Auditor Machinify is a leading healthcare intelligence company... ...primarily performs medical claims audit reviews with a focus... ...audits on claims for Government and Commercial Payers. You will work remotely in a fast-paced and dynamic...Remote workMedicalClaimsWork at office
- Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy,...Remote jobMedicalClaimsWork from home
$69.3k - $78k
...healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and Commercial Payers. The position... ...claims and documenting findings, all in a remote work environment. This role offers a...Remote jobMedicalClaims$59.3k - $80.9k
...part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records... ...ICD-10 and CPT coding guidelines, government regulation and protocols Complete... ...skills to make an impact Work Style: Remote, work at home. While this is a remote...Remote workMedicalClaimsBi-weekly payContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've... ...containment. Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...Remote workMedicalImmediate start
- ...IncPosted: 2026-09-04Empower AI is a government-focused tech company based in Reston, VA. We seek a Medical Review Coder Specialist to review Medicare claims and determine payments using ICD-10... ...with strong confidentiality. Remote/home-office security compliance may...Remote workMedicalClaimsHome office
- Walker Healthforce, LLC seeks a Medical Claim Review Nurse for a fully remote contract based in Washington. The role focuses on retrospective medical necessity reviews, appeals, and payment integrity within Molina Healthcare of Washington. The ideal candidate holds an active...Remote jobMedicalClaimsContract work
$78k - $88k
...It takes great medical minds to create powerful solutions that... ...individual for a Lead Coding Auditor, Itemized Bill Review and Appeals who is... ...perform reviews of multiple claim types to provide a flexible... ...expect in this role ~100% Remote Position ~ Up to 25% travel...Remote workMedicalClaimsFull timeContract workFlexible hours- ...Snapshot The Appeals Nurse examines medical records and claims information for first-level... ...are medically reviewed as needed and completed timely... ...Location We are open to remote work in the following approved... ...insurer and federal government contractor headquartered...Remote workMedicalClaimsContract workFor contractorsLocal areaImmediate start
- ...Medical Review SpecialistMedlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled... ...carriers; third party administrators (TPAs); and government entities we serve.ReviewWorks, a Medlogix...Remote workMedicalClaimsWork at office
$35 per hour
...more. Base pay range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift Position... ...adjudication of Federal Emergency Services (FES) 1500 claim forms. Some coordination will be required with medical...Remote workMedicalClaimsHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shift- Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a Medical Claim Review Nurse with strong...Remote jobMedicalClaimsContract workWork at officeImmediate startMonday to Friday
$40 - $55 per hour
...Medical Reviewer, RN Coder - Temporary Position Location: Remote *This role is a temporary position and employment is expected... ..., and analysis of medical claims, records, data, and audits between... ...Active license as a Registered Nurse, in good standing, in the United...Remote workMedicalClaimsHourly payTemporary workFor contractorsLocal area- ...Nurse Auditor Lewiston, ID Exp 5-7 years This position can be... ...conduct and report on post payment claims audits and performs related... ...: Proven knowledge of medical and surgical procedures and... ...Demonstrated competency in claim review and experience in using...Remote workMedicalClaimsWork at office
$80k - $95k
...Medical Review Nurse III Fully Remote Windsor Mill, MD Overview Salary Range $80,... ...purpose. We partner with government agencies to solve complex... ...complex medical record and claim reviews to make coverage... ...to support the Recovery Auditor Validation Contract (RVC)...Remote workMedicalClaimsFull timeContract workFor contractorsLive inWork at officeLocal area- ...Utilization Management Care Reviewer, you will be an... ...Networks Team. This 100% remote role manages a typical... ...departments including Claims. The schedule for your... ...Department, will determine the medical appropriateness of... ...Bachelor's degree in nursing or equivalent working knowledge...Remote workMedicalClaimsFull timeMonday to FridayShift work
- ...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 workMedicalClaimsFull time
- ...Description Physician Peer Reviewer – Multiple Specialties... ...Independent Medical Review Organization (IRO... ...healthcare organizations, government agencies, insurance... ...with independent review claims and appeals in any of... ...external reviews Job Type Contract Work Location Remote...Remote workMedicalClaimsContract workWork experience placementWork at office
- ...Elevance Health is seeking a Clinical Review Nurse I - Medicare Part B to review claims for medical necessity under Part B policies. The role is remote with required in-person training and follows a 8 am–5 pm EST Monday–Friday schedule. It’s part of Wellpoint Federal,...Remote workMedicalClaimsMonday to Friday
- ...healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an... ...participating in ongoing training. This is a part-time remote position, offering a flexible work...Remote workMedicalClaimsHourly payPart timeFlexible hours
$41 per hour
...Remote position, however, candidates must reside in the State... ...managed care industry using medically accepted criteria to validate... ...accurate and timely medical review of claims suspended for medical necessity... ...skills. # Registered Nurse (RN) with unrestricted license...Remote workMedicalClaimsContract work$78.91k - $98.64k
...of hospital inpatient claims and related inputs. Determines... ...Benefits : ~ Medical, Dental, Vision,... ...billing coordinator and/or auditor. # Certified Professional... ...# Prior experience in review of medical records.... ...connection required to support remote or hybrid work. Must be...Remote workMedicalClaimsHourly payFull timeWork at officeWork from homeAfternoon shift- Commence is seeking a Nurse Reviewer to perform complex medical record reviews of Medicare Part A/B and DMEPOS claims. The role requires clinical judgment to assess payment validity... ...to CMS guidelines. The position is remote, offering flexibility while demanding high...Remote jobMedicalClaims
$70.8k - $123.8k
...Clinical Nurse Auditor CGI is one of the world's... ...with commercial and government clients to deliver... ...clinical audits of medical records to determine... ...documentation skills to review inpatient and outpatient claims, evaluate medical... .... This position is remote within the United...Remote workMedicalClaimsWork at office- ...Claims Reviewer Location: Phoenix AZ 85053 (REMOTE) Duration: 6+ Months Pay Range: $28.00/hr on W2 Shift: Mon... ...retrospective review of medical/surgical claims and behavioral health... ...program payment. Ensures adherence to Government contract requirements. Provides...Remote workMedicalClaimsContract workFor subcontractorInterim roleShift work
- An established industry player is seeking a dedicated Registered Nurse for a remote contract position focused on reviewing medical claims within the insurance sector. This role involves validating treatment plans using accepted criteria and requires strong communication...Remote jobMedicalClaimsContract work
- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in Phoenix.... ...reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...the flexibility of a primarily remote work environment. If you are passionate...Remote jobMedicalClaims
- ...Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and DRG codes, and ensure... ...payment accuracy while supporting cost reduction. Remote work with occasional travel to Humana offices;...Remote workMedicalClaims
- A healthcare organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The role involves examining claims, maintaining... ...This position offers a chance to work in a remote setup with competitive hours. Benefits include...Remote jobMedicalClaims
- J29, Inc. is seeking a Remote Medical Reviewer (RN) for a temporary assignment to audit Medicare FFS claims, including Part A/B, DMEPOS, and Home Health/Hospice as needed. You will apply CMS rules, document findings, and ensure accuracy in each review while maintaining...Remote jobMedicalClaimsTemporary workWork experience placement
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