Remote Nurse Specialist II - Medical Claims & Compliance
Qlarant
Qlarant is seeking a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other claims data to ensure compliance and identify potential overpayment, fraud, waste, and abuse. This remote position allows work from the United States with standard annual compensation. The role requires an RN license, a minimum bachelor’s degree, and 2–4 years of experience (5–7 years preferred). #J-18808-Ljbffr
- ...Coder II Professional FeeInspired by faith. Driven... ...ensuring accuracy and compliance.Every day you will review... ...queues (charge review, claim edit, follow up),... ...this position is open to remote/out of state candidates... ...including but not limited to medical, prescription drug,...Remote workMedicalClaimsFull timeWork experience placement
- ...states. The Coding Analyst II performs high-level coding,... ...activities to ensure accurate medical coding within claims, reimbursement, and operational workflows. This remote role supports cross-functional... ...peers in coding quality and compliance. The position requires a...Remote jobMedicalClaims
$57.51k - $85.84k
...accommodation or an alternative application process. Nurse Specialist II Full Time Salary Special/Analyst II Remote, Remote, US Salary Range: $57,512.00 To $85,8... ..., Best Results Job Summary: Performs medical record and claims review for Medicare, Medicaid, and/or other claims...Remote workMedicalClaimsFull timeContract workWork experience placement- ...is one of the largest global medical technology companies in the world... ...4 days on site and Friday remotely on a weekly basis in... ...DescriptionThe Regulatory Affairs Specialist II is responsible for implementation... ...labeling and marketing claims for regulatory complianceProvide...Remote workMedicalClaimsFull timeWork at officeDay shift
$70k - $85k
...Risk Adjustment Coding Specialist II - Orange CountyWe are... ...diagnostic data from medical records to verify that... ...monitor, and document claims and encounter coding information... ...coding regulations, compliance guidelines, and... ...approximately 50% travel) with remote support to help...Remote workMedicalClaimsWork at officeWork from homeHome office$66.1 - $74.44 per hour
...Overview Requires review of medical record documentation to accurately... ...for each account in compliance with federal and state regulations... ...-DRG). The Inpatient Coding Specialist II is responsible for... ...modifiers to ensure a clean claim the first time through. Maintains...Remote workMedicalClaimsHourly payWork experience placementLocal area$60.78k
...and Grievances (A&G) Specialist II will receive, investigate... ...of complaints in compliance with Centers for Medicare... ...(DMHC), Managed Risk Medical Insurance Board (MBMIB... ...and complex provider claim disputes. The position... ...weekends, holidays, a hybrid remote schedule, occasional...Remote workMedicalClaimsFull timeLocal areaShift workWeekend work$80k - $85k
Risk Adjustment Coding Specialist II - San Francisco/San... ...diagnostic data from medical records to verify that... ...monitor, and document claims and encounter coding information... ...coding regulations, compliance guidelines, and... ...weeks that are fully remote, and then weeks where...Remote workMedicalClaimsFull timeWork at office- ...processes, the full-time Insurance Reviewer II will manage insurance claims, handle inquiries, and ensure timely... ...third-party payors while working remotely. Key responsibilities Handle phone... ...required Previous experience in a medical billing office required Working...Remote workMedicalClaimsFull timeWork at office
$61k - $113k
...000.00 Job Category: Claims Description At Liberty... ...optimizes both remote and in-person interactions... ...projects. The Claims Specialist analyzes complex Personal... ...Protection (PIP) and Medical Payment (Med-Pay) No... ...) or Claims Specialist II (grade 12) depending on...Remote workMedicalClaimsFull timeWork experience placementWork at officeLocal area- ...is seeking a full-time Certified Coder II to translate medical narratives into precise ICD-10 and CPT... ...outpatient, and complex records in a remote setting. You will review accounts, maintain... ..., you will review and resolve claim edits for billing based on payer and auditor...Remote workMedicalClaimsFull time
- ...EMPLOYERS is seeking a Workers’ Compensation Claims Adjuster II for a fully remote role based in the United States. The position handles moderate‑complexity claims, including medical, indemnity, and litigation, while delivering exceptional service to clients. The role...Remote workMedicalClaims
- ...Maryland Licensed Coding Specialist will analyze... ...records, ensuring compliance with billing and... ...guidelines while working remotely. Key... ...services Review medical records for accurate... ...resolve coding and claim edits using revenue... ...Coding Specialist II assessment upon hire...Remote workMedicalClaimsFull time
- ...EMPLOYERS is seeking a Senior Work Comp Claims Adjuster II to manage complex workers’ compensation claims with high medical and indemnity costs, including litigation. This remote role covers Nevada, Texas and Arizona. With 10+ years of adjusting experience in these...Remote workMedicalClaims
$77.12k - $138.81k
...spouses. USAA roles may offer remote or hybrid flexibility for... ...and manage business risks in compliance with internal risk management... ...background in trend analysis, claims analytics, and reserving.... ...benefits include comprehensive medical, dental and vision plans, 401...Remote workMedicalClaimsFull timeH1bWork at officeRelocation packageFlexible hours$155.25k
...as they relate to employment compliance, OSHA and workplace safety requirements... ...including employment-related claims, administrative charges, OSHA... ...be performed in an office, remote office or a combination of... ...employees are offered: Medical, Prescription, Dental &...Remote workMedicalClaimsFull timeContract workTemporary workPart timeWork at officeLocal areaImmediate start- ...for self-insured organizations, seeks a Workers' Compensation Claims Adjuster II. You will independently manage a portfolio of indemnity... ...judgment and strong knowledge of WC statutes, with emphasis on medical management, litigation, and recovery for self-insured clients...Remote workMedicalClaims
$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.... ...auditing claims and documenting findings, all in a remote work environment. This role offers a...Remote jobMedicalClaims- ...services, the full-time Collections Specialist II will ensure timely claims follow-up and corrections to meet... ...cash collection goals while working remotely. Key responsibilities Collect outstanding... ...Diploma or equivalent 3+ years of medical office or medical billing/...Remote workMedicalClaimsFull timeWork at office
- The University of Texas Southwestern Medical Center is seeking a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers. The role emphasizes follow-up and resolution of denied claims, with no direct billing...Remote jobMedicalClaims
$37.9 - $60.45 per hour
...sections and a 6-bed Level II nursery that cares for... ...gestation. Our nurses are NRP certified and trained... ...patient requests for medications, information and... ...Yes Looking for remote Have you ever been employed... ...of Federal Contract Compliance Programs (OFCCP)...Remote workMedicalHourly payFull timeContract workFor contractorsWork experience placementFor subcontractorReliefH1bH-2A VisaLive inH2bWork at officeLocal areaImmediate startVisa sponsorshipRelocation packageFlexible hours- ...UNITE HERE HEALTH seeks a Claims Adjudicator II to review and adjudicate medical, disability, vision and dental claims, ensuring eligibility and accurate payment... ...The position offers a 37.5-hour week, with fully remote work after one week of onsite training in Oak Brook,...Remote workMedicalClaims
- ...Revenue Cycle Specialist II - Ar & Denials Follow-Up *THIS IS A REMOTE POSITION* Primarily responsible for effective billing... ...offices. Is able to resolve claim issues by utilizing knowledge of company policies and procedures, medical coding, insurance reimbursement practices...Remote workMedicalClaims
- 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
- UT Southwestern Medical Center in Dallas seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals within the Revenue Cycle Department. The role emphasizes follow-up and resolution of denied claims and does not involve...Remote jobMedicalClaims
- Nationwide is looking for a Property Claims Adjuster II to work from home while servicing Northern San Antonio, TX area. The position demands... ...to provide exceptional customer service. Benefits include medical, dental, vision, and a 401(k) plan with company match. #J-1...Remote jobMedicalClaimsWork from home
- ...Coder IIThe Coder II reviews outpatient records... ...ResponsibilitiesReviews patient surgical medical records (hospital... ...accurate and timely claim submission and... ...Required orCertified Coding Specialist (CCS_AHIMA) Upon Hire... ..., FL, 32503, US (Remote)Job Schedule Full timeJob...Remote workMedicalClaimsLocal areaWork from homeShift work
- Medica is seeking a Coding Analyst II to perform high‑level coding, audits,... ...analysis to ensure accurate application of medical coding standards across claims and operations. The role supports... ...integrity and payment accuracy in a remote setting. The ideal candidate has a...Remote jobMedicalClaims
- ...a Triage Order Quality Associate II to join the Oncology Diagnostics team. This remote role focuses on verifying patient... ...authorizations, and accurately processing claims within Epic and other portals.... ...accounts while ensuring HIPAA compliance and high data integrity....Remote workClaims
$114k - $128k
...by A.M.Best. We are looking for a Claims Supervisor II - Commercial General Liability to join... ...that provides flexibility to work remotely while maintaining meaningful in-office... ...Volunteer Benefits Paid Vacation Medical Benefits Educational Incentives...Remote workMedicalClaimsWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Nurse Specialist II - Medical Claims & Compliance. Be the first to apply!
- clinical nurse specialist New York, NY
- associate degree nursing New York, NY
- software engineering manager remote New York, NY
- remote recruitment consultant New York, NY
- remote data manager New York, NY
- business intelligence analyst remote New York, NY
- benefits specialist remote New York, NY
- junior angular developer remote New York, NY
- remote video game New York, NY
- remote typing work New York, NY



