Remote Medicare Part B Clinical Review Nurse I
Elevance Health
Elevance Health is seeking a Clinical Review Nurse I – Medicare Part B. This role supports federal programs with virtual work and required in-person onboarding; occasional office locations may apply within a commuting distance. You will review claims for medical necessity using policy guidelines and communicate determinations clearly. Minimum requirements include AS in nursing with 1 year of clinical experience and an unrestricted RN license; residency rules apply for certain federal divisions. #J-18808-Ljbffr
- ...with the Centers for Medicare & Medicaid Services (CMS) reviewing the prior... ...criteria that Medicare Part D plan sponsors submit... ...management principles, sound clinical judgment, and the... ...principles for Part B versus Part D step... ...: US-based fully remote/work-from-home position...Remote workContract workTemporary workReliefSeasonal workWork at officeWork from home
- ...Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies, including cases requiring prior...Remote workLocal area
- ...Position Title Clinical Review Nurse - Prior Authorization Work Location Remote; nationally sourced within approved U.S. states. Must be available during standard... ...ongoing operational capacity and may be part of broader staffing needs. Key Responsibilities...Remote workWork at officeMonday to Friday
$22 per hour
...Call Center Representative in Detroit, MI. This is a temporary remote position, offering a pay rate of $22/hr. Candidates should... ...and be a High School Graduate. Join a dynamic team supporting Medicare Part B drug coverage inquiries and prior authorizations. #J-18808-Ljbffr...Remote workTemporary work$35 - $40 per hour
...Job Title: Clinical Prior Authorization Reviewer Job Description This role focuses on reviewing prior authorization... ...) Workplace Type This is a fully remote position. Application Deadline This... ...Intelligence (AI) to support parts of our hiring process, including sourcing...Remote workContract workTemporary workWork at officeShift work$104.21k - $156.31k
...Description: This part time position is 28... ...Summary: Supervise the clinical operations of all nursing floors in the absence... ...in writing annual reviews. And implement... ...staff development. ~ B.L.S. Certification required... ...Employer Remote Type: On-site Salary...Remote workPart timeImmediate startShift workWeekend workDay shiftAfternoon shift- ...OpenTrain AI is seeking a Nurse Practitioner Clinical AI Reviewer to evaluate AI-generated clinical responses and provide expert feedback on accuracy... ...and gold-standard answers to guide AI performance. This remote contractor role requires 20+ hours per week and supports...Remote workPart timeFor contractors
$53k
...physician assistants, and nurse practitioners... ...175 Madison Avenue Remote Type: On‑Site... ...Regular Time Type: Part time Work Shift: 1st... ...Becker's Hospital Review recognized Virtua Health... ...practitioners, and licensed clinical social workers who... ...accounts; 403(b) (401(k) subject to...Remote work16 hoursFull timeTemporary workPart timeLocal areaFlexible hoursShift workWeekend workDay shift- Loma Linda University Health is seeking a part-time Clinical Nurse B for the Med Tele/Onc Unit in Murrieta, CA. The role emphasizes patient-centered care, coordination, and documentation within LLUMC-Murrieta's practice model. The ideal candidate holds a BSN, at least...Part timeShift work
$27.02 - $48.55 per hour
...Performs concurrent reviews, including... ...necessity based on clinical policies and guidelines... ...Details This is a remote position. The required... ...School of Nursing or Bachelor’s degree... ...preferred. Knowledge of Medicare and Medicaid... ...including full-time or part-time status. Total...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours$27.02 - $48.55 per hour
...medical necessity and clinical reviews of authorization requests... ...Accredited School of Nursing or Bachelor’s degree... ...preferred. Knowledge of Medicare and Medicaid... ...approach to work with remote, hybrid, field or office... ...including full-time or part-time status. Total compensation...Remote workHourly payFull timePart timeWork at officeFlexible hours$78k - $84.03k
...LinkedIn. This is a part-time contract opportunity... ...of PointClickCare clinical notes for data input to... ...recommendations using nursing knowledge of Senior Living... ...experts involving quality review of AI products. -... ...policy. #LI-AV1 #LI-remote \n $37.50 - $40.40 an...Remote workFull timeContract workPart time10 hours per weekFlexible hours- ...Commence is seeking a Nurse Reviewer to perform expert medical record reviews of Medicare Part A/B and DMEPOS claims. You will apply clinical judgment to determine payment validity in line... ...clear rationales for actions. This remote role emphasizes HIPAA compliance and...Remote workLocal area
$69.8k - $125.9k
...careers. Join HCSC and be part of a purpose-driven... ...) Manager, the QOC Nurse conducts the review and investigation of... ...to, Centers for Medicare and Medicaid Services... ...assess and judge the clinical performance of physicians... ...available This is a remote role #LI- remote...Remote workFull time- Progressive Technology is seeking a Home-Based Product Reviewer to evaluate consumer technology products from home. The role is remote, flexible, and part-time, ideal for individuals passionate about technology and product analysis with no prior experience required. You...Remote jobPart timeWork from homeFlexible hours
$500 - $4,000 per month
## Part-Time Clinical Faculty, School of Nursing and Health SciencesApply: Part time: Posted Yesterday: R31308The... ...ability to video conference, etc.) at a remote location.* REQUIRED This role may... ...** or **FlexPath**). **Doctoral reviewer** assignments start at $200. #J-18...Remote workPart timeWork experience placementWork at officeAfternoon shift$90 - $110 per hour
• $90–$110 per hour • 100% remote • Part-time • Fully flexible schedule Apply below after reading through all the details and... ...attorneys. The teams building them need contract attorneys who can review realistic commercial agreements, judge whether the AI catches...Remote workHourly payContract workPart timeFor contractorsWork from homeFlexible hours$41.85 - $90.13 per hour
In-Home Nurse Practitioner or Physician Assistant Part Time - Lima### In-Home Nurse Practitioner... ...Time - LimaApply: Remote: OH - Lima: Part... ...medical history review, a physical... ...iPad and an intuitive clinical workflow for each evaluation... ....” - Ali B., NP**“I like how Signify...Remote workHourly payFull timePart timeLocal areaFlexible hours$14 per hour
A leading digital solutions provider is seeking a Content Reviewer for a part-time freelance opportunity. This role allows you to work from home while making a significant impact on technology. You will analyze and provide feedback on various types of information for major...Remote jobHourly payPart timeFreelanceWork from homeFlexible hours- ...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 workTemporary workWork experience placement
- ...Jobgether SRL is seeking a part-time remote clinical support professional to assist a Canada-wide healthcare team. You will provide essential clinical... ...follow-ups. Applicants must hold current Canadian nursing licensure (RN, RPN, or LPN preferred) with 3+ years of clinical...Remote workHourly payPart timeFlexible hours
- ...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 adjustments...Remote work
- ...members, the full-time Michigan Licensed Clinical Review Nurse will perform concurrent reviews to... ...contribute to discharge planning while working remotely from home. Key responsibilities... ...licensure required Knowledge of Medicare and Medicaid regulations preferred Familiarity...Remote workFull timeWork from home
- ...Conducting clinical reviews and authorizing prior approvals, the New Jersey Licensed Clinical Review Nurse will evaluate medical records, collaborate with healthcare providers,... ...regulatory standards, with the possibility of remote work during standard business hours. Key...Remote work
- ...for medical necessity, the full-time Florida Licensed Clinical Review Nurse will work remotely to ensure appropriate levels of care in accordance with... ...Registered Nurse (RN) licensure preferred Knowledge of Medicare and Medicaid regulations preferred Experience in hospice...Remote workFull time
- ...Ambetter marketplace members in Georgia, the full-time remote Georgia Licensed Clinical Review Nurse will perform concurrent reviews to evaluate members'... ...licensure or Compact RN licensure Knowledge of Medicare and Medicaid regulations preferred Familiarity with...Remote workFull time
- ...Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health status, medical necessity, and appropriate care levels, contributing to discharge planning within care policies and guidelines...Remote work
$114.4k
...surgical technology learners. Primary Responsibilities ~ Review AI-generated content related to surgical anatomy,... ...Preferred Qualifications ~ Experience in precepting, clinical instruction, or training ~ Experience across a variety...Remote workContract workPart timeReliefImmediate start- ...coordination, the full-time State Licensed Clinical Review Nurse will perform concurrent reviews of... ...providers, all while working remotely. Key responsibilities Conduct timely... ...Nurse required Preferred knowledge of Medicare and Medicaid regulations Familiarity...Remote workFull time
- ...Part-Time Clinical Nursing FacultyGeorgia Gwinnett College (GGC) is seeking candidates for the positions... ...the GGC Title IX Coordinator, Building B, Suite 3700, ****@*****.*** or (678) 4... ...applicant is selected for an interview. Review of applications will continue until positions...Temporary workPart timeWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicare Part B Clinical Review Nurse I. Be the first to apply!
- clinical nurse South Portland, ME
- nurse practitioner - telehealth South Portland, ME
- advanced nurse practitioner South Portland, ME
- nurse practitioner South Portland, ME
- neurosurgery nurse practitioner South Portland, ME
- electrophysiology nurse practitioner South Portland, ME
- nurse supervisor South Portland, ME
- nicu nurse manager South Portland, ME
- nurse director South Portland, ME
- matron South Portland, ME

