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 Clinical Appeals Auditor (RN) In October 2025, Machinify acquired... ...research, analyzes claims data, applies... ...company policies, government regulations and law... ...work independently in remote setting with... ...standing and diversified nursing experience providing...Remote workMedicalClaimsFlexible hours
$7.25 per hour
...down healthcare costs. The Medical Review Nurse - CMS / RAC (Government Audits) primarily performs medical claims audit reviews for... ...team of experienced medical auditors and coders performing retrospective... ...Payers. You will work remotely in a fast paced and dynamic...Remote workMedicalClaimsHourly payFull timeFor contractorsWork at officeShift work- Description Role Snapshot The Medical Review Nurse Analyst is responsible for... ...Nurse Analyst reviews claims and delivers provider education... ...We are open to remote work in the following approved... ...health insurer and federal government contractor headquartered in...Remote workMedicalClaimsContract workFor contractorsLocal areaImmediate start
$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$75k - $85k
...for a strong clinical nurse auditor to become part of our fast growing government-based healthcare practice... ...is responsible for reviewing policies and procedures... ...controls, and claims / medical records to determine an... ...position is a hybrid-remote position. Initial and...Remote workMedicalClaimsFull timeFor contractors$78.4k - $107.8k
...caring community. The Nurse Auditor 2 will perform Readmission... ...audits to ensure that medical record documentation... ..., Nurse Audit / Review. As the Nurse Auditor... ...Work from home position. Remote work requires appropriate... .... 1 or more years of claim review or auditing experience...Remote workMedicalClaimsTemporary workApprenticeshipWork from home$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 principles, government regulation, protocols Use your skills... ...Information WORK STYLE: Remote/Work at home; minimal travel may be...Remote workMedicalClaimsFull timeTemporary workApprenticeshipWork from home- ...Senior Auditor Employment Type: Full Time, Mid-level CGS... ...district legal staff by conducting medical claims data analysis, forensic... ...people together to solve the government's most dynamic problems with... ...and investigators. Review defense presentations, expert...Remote workMedicalClaimsFull timeFlexible hours
$78.4k - $107.8k
...caring community The Nurse Auditor 2 will perform... ...audits to ensure that medical record documentation and... ...Manager, Nurse Audit / Review. As the Nurse Auditor... ...~1 or more years of claim review or auditing experience... ...· Work Style: Remote/Work at Home. While this...Remote workMedicalClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$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... ...to make an impact WORK STYLE: Remote, work at home. While this is a remote...Remote workMedicalClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...mission of delivering high-quality at-home care, the full-time remote Medical Review Nurse will ensure compliance with CMS regulations for surgical... ...pilot a quality assurance process for surgical dressing claims, ensuring clinical completeness and billing correctness...Remote workMedicalClaimsFull time
$93.5k - $126.5k
...Nurse Analyst / Investigator We are GDIT... ...providers to the government, we own our opportunities... .... # Writing and reviewing edit proposals and... ...regarding policy, medical coding, and... ...policy, processes and claims payment systems... ...Options: Remote Work Location: Any...Remote workMedicalClaimsContract workFor contractors$70.3k - $85.47k
...The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on... ...of medical care. This is a remote position in CA. ESSENTIAL FUNCTIONS... ...specific issues of concern to the claims examiner/client and/or direct...Remote workMedicalClaimsMinimum wageFull timeWork at officeLocal areaFlexible hours$78.56k - $110.91k
...glance** **Location:** Remote **Facility:** Ascension... ...planning, and utilization review to support quality... ...and service requests for medical necessity, reimbursement... ..., reimbursement, and claim denials or appeals. + Coordinated... ...+ Licensed Registered Nurse credentialed from the...Remote workMedicalClaimsReliefLocal area- ...Precertification Nurse - LPN/RN Medlogix, LLC delivers innovative medical claims solutions through a seamless... ...(TPAs); and government entities we serve.... ...to Friday Location: Remote. Will need to be in Hamilton... ...Preferred InterQual/Review Manager/CERME CPT and...Remote jobMedicalClaimsFull timeWork at officeMonday to Friday
- ...at a glance** **Location:** Remote **Facility:** Ascension St. John Medical Center **Department:** Utilization Review **Schedule:** PRN, every other... ...revenue by preventing claim denials, ensuring proper status... ...Registration: + Registered Nurse credentialed from the Oklahoma...Remote workMedicalClaimsReliefLocal areaWeekend work
$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 Description... ...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- ...Medlogix, LLC delivers innovative medical claims solutions through a seamless... ...administrators (TPAs); and government entities we serve.... ...Provides comprehensive Medical Review Services, Medical Case Management... ...per week) Non-Exempt Remote- EST time zone POSITION...Remote workMedicalClaimsFull timeWork at office
- Machinify Inc. is seeking a Medical Review Nurse for remote work in the US. You will be part of a dynamic team, performing audits on medical claims, ensuring adherence to guidelines, and collaborating with other auditors. An associate or bachelor's nursing degree and experience...Remote jobMedicalClaims
- ...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
$84.06k - $118.67k
...A Glance Location: Remote Facility: Ascension... ...Department: Utilization Review Schedule: Days | Full... ...Comprehensive health coverage: medical, dental, vision,... ...and the management of claim denials or appeals.... ...~ Licensed Registered Nurse credentialed from the Florida...Remote workMedicalClaimsFull timeLocal area$78k - $88k
...Nurse Reviewer (Registered Nurse) - Remote in US It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join... .... Cross-trains to review multiple claim types to maintain workforce flexibility. Recommends...Remote workMedicalClaimsPermanent employmentFull timeContract workTemporary workMonday to FridayFlexible hours- ...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 workMedicalClaims
- ...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
$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 claims, collaborating with healthcare providers, and ensuring compliance with regulations. The ideal candidate...Remote workMedicalClaimsHourly pay- ...A leading healthcare 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 anywhere in the United States. Qualified candidates should possess...Remote workMedicalClaims
- ...Broadway Ventures is seeking a Remote Home Health RN to join their Medical Review team. The role focuses on conducting medical reviews to ensure compliance... ...Responsibilities include reviewing medically complex claims, providing rationale for coverage decisions, and supporting...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... ...Job Type Contract Work Location Remote...Remote workMedicalClaimsContract workWork experience placementWork at office
- ...a Clinical DRG RN auditor, you will apply your... ...of inpatient claims. Employing both industry... ...APR-DRG coding reviews to verify the accuracy... ...accuracy of medical coding and utilize... ...Unrestricted RN (Registered Nurse) license CCS/CIC... ...in a remote environment and deliver...Remote workMedicalClaimsTemporary workWork at officeRelocation package
- ...applicants This is full-time remote, but candidates must reside... ...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 workMedicalClaimsFull timeContract work
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