Remote SNF Medical Review Nurse | Claims Auditing
Machinify
- Remote job
Machinify is hiring a Medical Review Nurse II to perform audit reviews of medical claims for skilled nursing facilities. In this remote role, you'll work as part of a dynamic team to ensure compliance and appropriate service delivery. Responsibilities include reviewing claims, documenting findings, and supporting the audit process. Candidates must possess an active RN license and extensive nursing experience, particularly with MDS and medical records review. This position offers the opportunity to influence healthcare outcomes while working collaboratively across teams. Join us in contributing to improved efficiency and transparency in healthcare services. #J-18808-Ljbffr Machinify
$84k - $100k
A leading healthcare intelligence company is seeking a Medical Review Nurse II to perform audits on medical claims for government and commercial payers. This remote position requires a minimum of five years of nursing experience and an active RN license. Responsibilities...Remote workMedicalClaims$78.5k - $90k
...Performant Recovery, Inc. is hiring a Medical Review Nurse for remote work focusing on auditing medical claims for Home Health services. This role involves document audits, collaboration with audit teams, and staying updated on regulatory issues. The ideal candidate will...Remote workMedicalClaims- 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,...Remote jobMedicalClaims
- ...designated clinical resource to review High Cost Claimants to... ...information related to members' claims and clinical course, expected... ...with other departments such as medical and pharmacy account team to address... .... Support clinical quality audit activities under the direction...Remote jobMedicalClaimsFull time
- ...Medical Review Nurse - CMS RAC In October 2025, Machinify acquired Performant and we... ...Review Nurse - CMS RAC (Government audits) primarily performs medical claims audit reviews for government... ...Commercial Payers. You will work remotely in a fast paced and dynamic environment...Remote workMedicalClaimsFor contractorsWork at officeShift work
- Machinify is seeking a Medical Review Nurse II to perform medical claims audit reviews for Government and Commercial Payers. This role requires an active RN license... ...2 years of relevant experience. The position is remote, and you will be part of a dynamic, multi-location...Remote jobMedicalClaims
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain subject... ...reviews on medical review audit work completed by the... ...conducts research, analyzes claims data, applies knowledge of client... ...to work independently in remote setting with minimum...Remote workMedicalClaimsFlexible hours- ...-5pm Work Location: Remote Benefits for eligible... ...and utilization review. Review admissions and... ...concurrent and retrospective medical necessity and/or... ...precertification, reimbursement and claim denials/appeals.... ...Need ~ Registered Nurse credentialed from the Alabama...Remote workMedicalClaims
- ...commercial insurance - we want to meet you. Medical Review Nurse Carbon Stop Loss Solutions is a... ...best-in-class service, underwriting, claims support and effective cost containment... ...Ability to work independently in a remote setting. Ability to work with multiple...Remote workMedicalClaims
$70.3k - $85.47k
...The Professional Review Nurse provides analysis of medical services to determine appropriateness... ...care. This is a remote position in CA.... ...issues of concern to the claims examiner/client and/or direct... ...preferred Medical bill auditing experience preferred Experience...Remote workMedicalClaimsMinimum wageFull timeWork at officeLocal areaFlexible hours$85k - $90k
...match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG... ...: CCS, CPC, CIC Coding validation/auditing experience Well-developed verbal and written...Remote workMedicalClaimsWork at office$68k - $70k
Description Our Medical Review Nurse Analyst is responsible for conducting clinical reviews of medical... ...Medical Review Nurse Analyst reviews claims and delivers provider education on... ...skills, and experience. We are open to remote work in the following approved states:...Remote workMedicalClaimsContract workFor contractorsLocal areaImmediate start$64k - $80k
It takes great medical minds to create powerful solutions that solve... ...As a Fraud and Abuse Review Nurse- Remote at Gainwell, you can contribute... ...objective desk and medical record audits to verify service... ...Services, Member Services, Claims) to collect relevant documentation...Remote workMedicalClaimsFull timeLocal areaWork from homeFlexible hours$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$86k - $105k
...It takes great medical minds to create powerful... ...of the Lead Nurse Consultant and Deputy... ...payment compliance reviews to detect, combat,... ...financial records, claims, and claims data to... ...documentation supporting audit or investigative... ...Wisconsin Role is 100% remote Employees may be...Remote workMedicalClaimsFull timeWork at officeFlexible hours$85k - $90k
...Outlier and Readmission reviews. Under the direction... ...reviews of inpatient claims for both coding accuracy... ...College level courses in medical terminology, anatomy,... ...care inpatient coding, auditing. Payment integrity DRG... ...different tasks easily. Remote Work Requirements:...Remote workMedicalClaims- ...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 within the U.S. and demands strong clinical skills along with a comprehensive understanding of...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
- ...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 jobMedicalClaimsFor contractorsLive in
- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching... ...team and maximize client savings by reviewing medical bills from a nurse perspective... ...statements, and will: Audit medical and billing records to determine...Remote workMedicalImmediate start
$80k - $95k
...Medical Review Nurse III Fully Remote Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000.00 Salary Position Type Full Time Education... ...programs. Perform automated and complex medical record and claim reviews to make coverage determinations based on...Remote workMedicalClaimsFull timeContract workFor contractorsLive inWork at officeLocal area$62.7k - $100.4k
...PI Medical Coding Reviewer III (CPC, RHIT or RHIA required) Apply ( locations Remote time type Full time posted on Posted 7 Days... ...most complex medical record audit programs, dispute management... ...departmental teams such as Claims, Configuration, Health...Remote workMedicalClaimsHourly payFull timeWork experience placementWork at office- ...Role The Casualty Bill Review Specialist is... ...compliant, and efficient medical bill review within the... ...requirements. *This is a remote role. Primary Responsibilities... ...WCB compliance and audit readiness. Essential... ..., and internet sites claiming to represent Brighton...Remote workMedicalClaimsLocal areaFlexible hours
- ...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
- ...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
- ...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
- ...Broadway Ventures LLC is looking for a dedicated Registered Nurse (RN) to join its Medical Review team. This remote position involves conducting pre- and post-payment medical reviews and requires an active RN license and relevant clinical experience. Ideal candidates will...Remote workMedicalClaimsWork at office
- ...resources About the Role: Join MedPOINT Management as a Medical Claims Clinical Review Nurse in Sherman Oaks, CA, where you'll play a crucial role in... ...us and be part of a team that makes a difference in the lives of patients every day. This is a remote position....Remote workMedicalClaims
- Description: Nurses – are you looking for a change?... ...and benefits, including medical, dental, vision, long-term... ...Work-life balance. ~ Remote setting ROLE... ...decision to a second level reviewer. This individual... ...’s status, benefit and claim concerns, and validation...Remote workMedicalClaimsTemporary workWork at officeMonday to FridayFlexible hours
$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals)... ...*** Location: Remote (can sit anywhere in the... ...benefits review, supporting Medical Review Analysts, and Physician... ...expands. 4. Claims assessment and... .... Licensed, Registered Nurse in NYS, required....Remote workMedicalClaimsLocal areaImmediate startFlexible hours
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