Remote Claims Review Nurse - Dispute Resolution Expert
Capitol Bridge.
- Remote job
Capitol Bridge seeks an experienced Claims Review Nurse to resolve healthcare claim disputes under state IRO programs. You will evaluate documentation, coordinate with clinical reviewers, and work with health plans, providers, and enrollees to reach timely determinations with accuracy and professional integrity. This remote position supports state-wide health plan disputes, requires active nursing licensure and at least five years of patient care experience, and emphasizes compliance with CPT #J-18808-Ljbffr Capitol Bridge.
$70k - $85k
...Medical Reviewer, RN Location: Remote Salary: $70,000-85,000 annually, based... ...and analysis of medical claims, records, data, and audits... ...Reviewers participate in dispute resolution by re-examining claims and... ...license as a Registered Nurse, in good standing, in the...Remote workClaimsFull timeFor contractorsLocal area$75k - $85k
Job Details Job Location: Remote - Remote Employees, VA 12345 About... ...independent medical reviews, records/data management services... ...ReviewNurse. The Claims ReviewPositionwill play a crucial... ...Statewide Health Plan Claim Dispute Resolution(FL CDR)Program under the Agency...Remote workClaims- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis of hospital facility bills. You... ...a broad policy framework and must understand the claim review process, clinical review, medical record review...Remote jobClaims
- ...Job Description Job Description Alternative Dispute Resolution (ADR) Claim Adjuster Remote At Frontline Insurance, we are on a mission to Make... ...Alternative Dispute Resolution (ADR) Claim Adjuster: Review assigned claims promptly. Formulate and execute...Remote workClaimsTemporary workLocal area
- A leading consulting firm is seeking a Dispute Resolution Director in Houston, Texas. This role involves providing leadership in construction disputes, managing multiple cases, and expanding the client base. Ideal candidates will have over 10 years of experience, strong...Claims
- ...hands-on Medical Bill Review (Working) Supervisor to... ...serve as a Subject Matter Expert (SME) and Expert... ...complex, high-dollar, or disputed medical bills (e.g., trauma... ...are provided for remote workspace. About Dane... ...over 200,000 insurance claims annually for leading national...Remote workClaimsContract workTemporary work
- ...Registered Nurse: Review and Evaluation Are you a registered nurse ready to take your career... ...bedside setting to review and audit claims, support program integrity initiatives,... ...outcomes for vulnerable populations Remote work enjoy the convenience and balance of...Remote jobClaimsWork from home
- ...Description Are you a registered nurse ready to take your career in an exciting... ...ofthe traditional bedside setting to review and audit claims, supportprogram integrity initiatives,... ...for vulnerable populations Remote work - enjoy the convenience and balance...Remote workClaimsFull timeTemporary workWork at officeWork from home
- ...Schneid, Crane & Partners, PLLC is seeking a Title Curative Specialist for a remote role. The specialist reviews title issues, assists clients with curing problems, and coordinates with the title claims team while keeping clients informed about progress. Strong documentation...Remote jobClaims
$29 - $52 per hour
...together. The Clinical Claim Review RN will be responsible... .... The Sr. Recovery Resolution Analyst will present and... ...schedule. This position is Remote in Massachusetts. You... ...and participate in dispute reviews and... ...equivalent work experience Nurse licensure (RN or LPN)...Remote workClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- ...an alternative application process. Review Nurse, Pediatric Review Regular Full-Time Professionals... ...required. Assists providers with resolution of claims edit issues as needed. Completes... ...environment, but may be conducted in remote or field locations. The role may require...Remote workClaimsFull timeContract workTemporary workWork at office
- Gainwell Technologies is seeking a Medical Reviewer (Durable Medical Equipment Specialist) to provide subject-matter expertise supporting... ...In this role, you will review durable medical equipment (DME) claims, Treatment Authorization Requests (TARs), prescriptions, and...Remote jobClaims
- ...Description Seeking a Registered Nurse (RN) – Expert Medical Examination... ...program integrity and medical review initiatives in a full-time,... ...hybrid schedule (three days remote, two days onsite). This position... ...medical record reviews, claim evaluations, and clinical assessments...Remote jobClaimsLong term contractFull timeContract work
- J29, Inc. seeks experienced RVC Reviewers to perform automated and complex reviews of Medicare FFS claims, ensuring proper payments and adherence to CMS rules. The role... ...medical coding, experience with DRG validation, and remote work capability. This position supports ongoing...Remote jobClaims
$150k
...Description Title: Construction Claims Principal Expert Direct Supervisors:... ...Location: Hybrid, and remote options Description:... ...A Construction Claims and Dispute Resolution Specialist capable of handling... ...Contractual Oversight: Reviewing contract terms (e.g.,...Remote workClaimsFull timeContract workWork at officeWork from homeRelocation packageFlexible hours- ...GIS & Geospatial Expert — AI Output Review (Remote) is a remote review track for evaluating AI outputs across... ..., calculations, or experimental claims. Flag dimensional, methodological... ...team can train on it. Adjudicate disputed answers against textbooks, papers, or...Remote jobClaimsHourly payFor contractors10 hours per week
$150k - $175k
...healthcare company, is seeking a Dispute Resolution Attorney The successful... ...(prefer hybrid but open to remote candidates as well) Duration... ...internal clients to evaluate claims and/or defenses in a variety... ...work with the subject matter expert to amend the underlying...Remote workClaimsContract workPart timeWork from homeWorldwide- CorVel Corporation is seeking an Itemization Review Nurse to assess charges on UBIB submissions for accuracy. This remote role requires meticulous data review and documentation in the designated system. The ideal candidate holds RN licensure in the employment state, with...Remote job
- CERIS, a division of CorVel Corporation, is seeking an Itemization Review Nurse for a remote role in the United States. The nurse analyzes charges on UBIB submissions to ensure billing accuracy and documents conclusions in the company system. Requires RN licensure and 5...Remote job
- SafeGuard Services (SGS), a Peraton subsidiary, is seeking a Nurse Reviewer to join our team. You will conduct medical record reviews and apply clinical judgment to claim payment decisions, researching claims data to detect patterns of fraud and ensure medical necessity...Remote jobClaims
- Trillium Health Resources is seeking a Compliance Nurse to join our NC-based team. This exempt, full-time role focuses on clinical compliance reviews and claims evaluation to ensure regulatory adherence and proper payments. You will assess documentation, enforce coverage...Remote jobClaimsFull time
- WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to prepare timely redeterminations...Remote jobClaims
- 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 jobClaimsWork from home
- ...Clinical Validation Reviewer Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures... .... Must Have Skills: Expert in DRG methodologies (e.g.,... .../ Education: Registered Nurse (RN). License must be active...Remote workClaimsWork at office
- ...Claims Review Management Nurse (RN) We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program... ...in Harrisburg, PA, with a hybrid schedule (three days remote, two days onsite). This position plays a critical role in...Remote workClaimsLong term contractFull timeContract workWork at office2 days per week
$41 - $43 per hour
...AltaStaff is a staffing agency currently looking for a Medical Claims Review Nurse to work with our Managed Care Client! Location: Remote (Candidates must reside in NY (outside greater NYC), FL, GA, MI, OH, WI, IA, NM, TX or KY) Pay Rate: $41 - $43.00 hourly...Remote workClaimsHourly payWork at officeLocal area$2,732 - $4,682 per month
...about Louisiana Works The Workers' Compensation Dispute Resolution Specialist 1/2 will provide support services to the Workers... ...workplace safety. The department manages disputed claims, conducts hearings, reviews medical treatment disputes, and investigates fraud...ClaimsFull timeWork experience placementWork at office- ...build something that matters. As Medical Reviewer, you'll be shaping the future of at-home... ...correctness) and pilot it on all surgical‑dressing claims. Create/upgrade templates for... ...16–A6221 gauze; A6257–A6259 film). ~ Expert with proof‑of‑delivery standards, SWO...Remote workClaims
$30 - $40 per hour
...RN Clinical Review Nurse (Utilization Review Nurse)The Clinical Review... ...Generate appropriate appeals resolution communication and reporting for... ...denials and retrospective claim denials to determine medical... ...Workplace Type:This is a fully remote position.Application Deadline...Remote workClaimsContract workTemporary work- Overview Job Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working hours: Day Shift Job Type: Subcon Pay Rate: Negotiable Position Description The Quality Analyst is responsible for ensuring...Remote workClaimsContract workDay shift
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