Remote Medical Review Nurse: Commercial DME Auditor
Machinify
- Remote job
Machinify is seeking a Medical Review Nurse II – Commercial DME to perform retrospective and prepayment medical claims audits for Government and Commercial payers. This remote U.S. role joins a multi-location team of expert auditors and coders, delivering high-quality reviews in a fast-paced environment. You will audit inpatient and outpatient claims, reference MCG/InterQual guidelines, document findings, generate audit letters, and support appeals as needed while collaborating with clients and #J-18808-Ljbffr Machinify
- Machinify is seeking a Medical Review Nurse II - Commercial DME to perform retrospective/prepayment audits on government and commercial payer claims. This remote role requires handling desk audits, documentation of findings, and supporting appeals in a fast-paced environment...Remote jobCommercialMedical
- Machinify is seeking a Medical Review Nurse II - Commercial DME to perform retrospective and prepayment medical claims audits for Government and Commercial Payers. The role is remote, joining a multi-location audit team with a focus on quality, policy adherence, and documentation...Remote jobCommercialMedical
- ...and drive down healthcare costs. The Medical Review Nurse II - Commercial DME primarily performs medical claims... ...join a team of experienced medical auditors and coders performing retrospective... ...and Commercial Payers. You will work remotely in a fast paced and dynamic...Remote workCommercialMedicalFor contractorsWork at office
- Medical Review Nurse - Commercial DME Auditor Remote - US Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by...Remote workCommercialMedicalFor contractorsWork at office
- Machinify is seeking a Medical Review Nurse II - Commercial DME to audit medical claims for appropriate services in inpatient and outpatient settings. This remote role supports government and commercial payers in a fast-paced, cross-functional team. You will document findings...Remote jobCommercialMedical
$90k - $105k
...consider applying for one of our other Medical Review Nurse roles, which may be a better fit... ...a team of experienced medical auditors performing retrospective and... ...audits on claims for Government and Commercial Payers. You will work remotely in a fast-paced and dynamic environment...Remote workCommercialMedicalFull timeFor contractorsWork at office- ...prepayment audits on skilled nursing facility (SNF) claims for government and commercial payers. Work remotely in a fast-paced, dynamic environment... ...: Audit claims for medically appropriate services in SNF settings, applying medical review guidelines and policies. Document...Remote jobCommercialMedicalFor contractorsWork at office
$50k - $65k
As a DME Auditor , you’ll use your deep understanding of Durable Medical Equipment (DME) , Medicare , Medicaid , and commercial reimbursement rules to review professional claims and ensure proper coding and... ...working independently in a remote environment. Strong written...Remote workCommercialMedicalContract work- ...Nurse Auditor Remote We are seeking a detail-oriented Registered Nurse (RN) Auditor to support... ...validation. In this role, you will review medical records and itemized bills to ensure... ...with Medicare, Medicaid, and commercial payer billing guidelines, CMS regulations...Remote workCommercialMedicalTemporary work
- ...Have you ever looked a medical bill and immediately noticed something was wrong? Were... ...Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the... ...our team and maximize client savings by reviewing medical bills from a nurse perspective,...Remote workMedicalCasual workWork at officeImmediate startFlexible hours
- Machinify is seeking a Medical Review Nurse to perform CMS/RAC audits for government payers. This remote role involves working with a multi-location team to review claims, document findings, and support appeals. RAC certification is preferred and candidates may work toward...Remote jobMedical
- ...Job TitleThis is a remote position but will need onsite... ...beginning day one (Medical, Dental, Vision, PTO,... ...Will DoConduct clinical reviews of patient records to... ...with physicians, nursing staff, and interdisciplinary... ..., Medicaid, and commercial insurance guidelinesSolid...Remote workCommercialMedicalFull timePart timeWork at officeLocal areaShift workDay shift
- ...Medical Review Nurse Carbon Stop Loss Solutions is a leading managing general underwriter (MGU... ...25 sale of NSM Insurance Group's U.S. commercial division. We're building something bold... ...Ability to work independently in a remote setting. Ability to work with multiple...Remote workCommercialMedicalHome office
- Clinical Review Nurse - Concurrent Review TX All On-site Share on Job Description Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday... ...faxed in by facilities for medical necessity. The nurse gains valuable regarding commercial insurance. Performs concurrent...Remote jobCommercialMedicalContract workWork from homeShift work
$85.7k - $129.31k
...RN Charge/Coding Auditor is responsible for... ...charge audits of medical records on behalf... ...clinics for denials review, defense audits, disallowed... ...as well for fully remote position.... ...determine viability for commercial and governmental... ...school of nursing. Bachelor of Science...Remote workCommercialMedicalHourly payFull timeWork at officeFlexible hours- ...inclusion. Our company is fully remote and offers a flexible work... ...offers 100% employer paid medical, vision, dental, and life coverage... ...position of UM Outpatient Review Nurse reports to the Director,... ...InterQual guidelines. Medi-Cal, Commercial and Medicare contracts and...Remote workCommercialMedicalWork at officeFlexible hoursWeekend work
$75k - $80k
...Hiring Range: $75,000 - $80,000. The Medical Review Nurse II - Home Health primarily... ...join a team of experienced medical auditors and coders performing retrospective... ...on claims for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment...Remote workCommercialMedicalFor contractorsWork at officeWork from homeHome officeShift work$107k - $119k
...experts in the Commercial & Government Audit... ...mentoring the auditor and providing documented... ...and Specialty Review Types to include... ..., IRF, and HH, DME, Hospice, and medical necessity.... ...Bachelor’s degree in Nursing, Healthcare... ...selected. #LI-Remote #LI-JJ1...Remote workCommercialMedicalHourly payContract workFor contractorsWork at officeImmediate start- ...Management, LLC dba Viemed is seeking an Utilization Review Coordinator to review patient records for therapy coverage and medical necessity. In this full-time role, you will... ...documentation against Medicare, Medicaid and commercial payer criteria, and document findings in the...CommercialMedicalFull timeMonday to Friday
$40 - $50.48 per hour
...Utilization Management and inpatient review experience? We’re hiring for a 100% REMOTE opportunity focused on... ...rounds Collaborate with Medical Directors, physicians &... ...California RN or LVN license Commercial UM background (nurses who possess a fast pace and a...Remote workCommercialMedicalContract workTemporary work$50k - $65k
As a DME Auditor , you’ll use your deep understanding of Durable Medical Equipment (DME) , Medicare , Medicaid , and commercial reimbursement rules to review professional claims and ensure proper coding and payment. You’ll analyze claims, document your findings clearly...CommercialMedical- A leading medical service provider in Washington, DC is seeking a DME Medical Reviewer to ensure compliance with nursing standards and provide comprehensive management reports. The ideal... ...performing quality audits. The role emphasizes remote work capabilities and adherence to...Remote jobMedical
- ...documentation, insurance claims, medical records, and regulatory... ...to Medicare, Medicaid, commercial insurance, and... ...documentation. Review documentation to ensure... ...payer regulations, and DME industry standards. Monitor... ...with opportunities for remote work depending on department...Remote workCommercialMedicalFor contractorsWork at office
- CoventBridge Integrity Systems is seeking a Medicaid Medical Review RN (Medical Reviewer III) for remote work with potential on-site audits in Grove City, OH. The role focuses on clinical reviews of medical records during fraud investigations and applies Medicare/Medicaid...Remote jobMedical
- Join a team of experienced medical auditors and coders performing audits for government payers. Work remotely in a fast-paced, dynamic, multi-location team. Responsibilities... ...: Active RN license and five years of nursing experience required. ICD-10, CPT/HCPCS, and...Remote jobMedical
- ExamWorks is seeking a Utilization Review Nurse Auditor to perform quality utilization reviews and authorize medically necessary care. The role is fully remote with standard EST hours, requiring an active nursing license and coding certification. You will work with providers...Remote jobMedical
$33 - $46 per hour
ExamWorks is seeking a Utilization Review Nurse Auditor to join our team. This fully remote role requires RN/LPN/LVN licensure and strong medical terminology, anatomy, and physiology knowledge to review care for medical necessity according to evidence-based guidelines....Remote jobMedicalHourly payMonday to Friday- ...DescriptionJob Description Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time... ...Utilization Review Nurse to evaluate the medical necessity, appropriateness, and... ....Knowledge of Medicare, Medicaid, commercial insurance, and managed care...Remote workCommercialMedicalFull timeSecond jobWork at office
$82k - $87k
...Guidehealth leverages remotely-embedded... ...Clinical Compliance Auditor II is responsible... ...Serving as a secondary reviewer for denial documentation... ...Registered Nurse (RN) license required... ...of Medicare, Commercial Managed Care, and... ...offer comprehensive Medical, Dental, and Vision...Remote jobCommercialMedicalBi-weekly payFull timeTemporary workFor contractorsWork at officeLocal areaWork from home$69.3k - $78k
...payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform... ...medical claims audits for Government and Commercial Payers. The position requires an... ...claims and documenting findings, all in a remote work environment. This role offers a competitive...Remote jobCommercialMedical
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