Remote Payment Integrity Nurse I
Cambia Health Solutions
- Remote job
Cambia Health Solutions is seeking a Payment Integrity Nurse I to perform post service reviews of claims, ensuring accurate coding and appropriate reimbursements. You will apply medical policies and collaborate with physician advisors to support fair determinations. The role requires a clinical background with at least 3 years of direct care experience and an unrestricted RN license. Remote work is available within Oregon and neighboring states, with a focus on accurate, ethical healthcare #J-18808-Ljbffr Cambia Health Solutions
- Cambia Health Solutions in the United States is hiring a Payment Integrity Nurse I to review post-service claims and ensure accurate coding within defined medical policies. The role supports patient care while maintaining compliance and high-quality review standards. You...Remote jobWork from home
- Cambia Health Solutions is seeking a Payment Integrity Nurse I to review claims and medical records for accurate payments. The role supports post service review and coding guidelines within the Post Service Claim Review team. The position requires clinical experience, RN...Remote jobFlexible hours
- Cambia Health Solutions is seeking a Payment Integrity Nurse I to perform post-service claims reviews, ensuring accurate coding, proper payment... ...care and claims integrity while working within a flexible remote model across certain western states. The position emphasizes...Remote jobFlexible hours
- Abacus Insights is seeking a Complex Clinical Audit (CCA) Business Solutions Lead with 5+ years in payment integrity to translate payer needs into scalable product logic. You’ll work with AI Engineering on backend build, demo capabilities to major payers, and shape how...Remote job
- Centene Corporation is seeking an experienced RN with coding credentials to lead Payment Integrity initiatives focused on preventable readmissions, cost recovery, and payment accuracy across the enterprise. You will supervise auditors and clinical staff and ensure alignment...Remote job
$87.7k - $157.8k
...recovery, cost avoidance, and payment accuracy. You will lead a... ...progressive experience in Payment Integrity, including readmission review... ...Information Management, Nursing, or a related field required;... ...flexible approach to work with remote, hybrid, field or office work...Remote workFull timePart timeWork at officeFlexible hours- ...business case development for proposed initiatives, the full-time Payment Integrity Specialist will support strategic planning, manage cross-... ...initiatives, and ensure effective execution while working remotely. Key responsibilities Lead business case development to...Remote workFull time
$76.5k - $103.5k
...person-focused and economically sustainable health care system. Who We Are Looking For Every day, Cambia’s dedicated team of Payment Integrity Nurses are living our mission to make health care easier and lives better. As a member of the Post Service Claim Review team, our...Full timeImmediate startWork from homeFlexible hours- ...Payment Integrity Specialist Council Capital is a healthcare-focused private equity firm based in Nashville, Tennessee, managing over $350 million in committed capital. We invest in lower middle market healthcare companies where we see the potential to scale purpose...Remote workLive inShift work
- Senior Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be based in EST or CST and must be comfortable working EST-hours Terms of Employment This position is 100% remote. Candidates must...Remote workContract work
- ...re a fast-growing fintech in the B2B cross-border payments space, and we need a Payment Operations and Integrations Engineer to ensure our customers have a seamless... ...at a well-funded early-stage startup Fully remote first, with in-person international team offsites...Remote workFull timeWork from homeFlexible hours
- ...Registered Nurse: Review and EvaluationAre you a registered nurse ready to take your career in an exciting new direction—one where... ...Organization and step into a dynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion the needs...Remote workWork from home
- ...Experience Manager at Rialtic, Inc. Atlanta or Remote About Rialtic Rialtic is an enterprise... ...Partners, Rialtic’s best‑in‑class payment accuracy product brings programs in-... ...than relationship‑focused. Values High Integrity - Do the right thing, provide candid feedback...Remote workWork from homeHome office
- A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...Remote work
$75k - $90k
The Quality Analyst - Data Mining, Payment Integrity plays a key role in ensuring the accuracy, quality, and consistency of audit work performed... ...on experience, skills, and qualifications) Location: 100% Remote (U.S.-based) Up to 10% annual travel (for team meetings and...Remote workFull time- ...Shift Day Shift Description Purpose Work Remote Positon The Nursing Support (NS) colleague (uncertified,... ...laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct... ..., managed care or comparable patient payment processing experience preferred. AAPC...Remote jobFull timeLocal areaShift workDay shift
- CERIS is seeking a Policy & Payment Integrity Coordinator to manage workflow, assign appeals, and maintain tracking systems. The role emphasizes... ...priorities in a fast-paced environment. The position is remote and aligns with CorVel’s ACE‑IT values. The PPI Coordinator will...Remote job
- Optum is seeking a Sr. Technical Product Manager for Payment Integrity to lead strategy and delivery for scalable platform capabilities. This remote role partners with engineering, architecture, operations and business leaders to drive value across multiple portfolios....Remote job
- ...Job Description Are you a registered nurse ready to take your career in an exciting... ...adynamic role focused on advocacy and program integrity through compliance management. Here, you'... ...outcomes for vulnerable populations Remote work - enjoy the convenience and balance...Remote workFull timeTemporary workWork at officeWork from home
- ...seeks a Senior Product Manager for Professional Claims Review - Payment Integrity. You will define strategy, own roadmaps, and guide cross-... ...and GTM to deliver measurable client value. This role offers remote work anywhere in the U.S. with in-office requirements in Minneapolis...Remote jobWork at office
- ...leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations... ...on improving service delivery. This remote position requires strong experience in... ...Candidates must hold an Associate Degree in Nursing and RN licensure. #J-18808-Ljbffr...Remote jobDaily paid
- Presbyterian Healthcare Services is hiring a Medical Economics Analyst-Payment Integrity for a remote position based in New Mexico. The role focuses on identifying cost savings, validating payments, and aligning initiatives with total cost of care. Strong SQL/SAS skills...Remote job
- CorVel Corporation seeks a Payment Integrity Analyst (Team Lead) to supervise the Policy and Payment Integrity (PPI) team while overseeing audits... ..., staff training, and timely completion of audits, with a remote work arrangement. Strong knowledge of CMS policies, ICD-10...Remote job
$98.2k - $163.6k
## Business Analytics Advisor, Payment Integrity - Cigna Healthcare - RemoteApplyremote type: Remotelocations: United States Work at Home: Chattanooga, TN: Bloomfield, CT: Scottsdale, AZ: Denver, COtime type: Full timeposted on: Posted Todayjob requisition id: 26009249*...Remote jobWork from home- KeyBank is seeking a Specialty Solutions Consultant for Integrated Payments to support merchant referrals and partnerships remotely in the United States. The role collaborates across sales, operations, credit, underwriting, product, and risk to deliver a seamless partner...Remote job
- ...strategy for our Facility Claim Review solutions within Optum Payment Integrity. You will own the product vision, roadmap, and measurable... ...solutions, balancing strategic vision with execution and cross-functional leadership. Remote work across the U.S. #J-18808-Ljbffr OptumRemote work
- Zact Inc. is seeking an experienced payments professional to own the delivery of issuer processor integrations and major implementation projects. This role goes beyond traditional project management and requires coordinating technical teams, processor personnel, banks,...Remote job
- SmartLightAnalytics in Plano, TX is seeking a Manager of Payment Integrity to bridge clinical expertise and business operations, evaluating reimbursement processes and guiding program strategy with data-driven insights. You will mentor the Clinical Analysts and partner...
- ...First (Days) Overview: Sentara Health Plansis hiring an Integrated Nurse Case Manager/Registered Nurse/RN for Chronic/Complex Condition... ...of Care, TOC, Virginia Fredericksburg, Spotsylvania, VA, Remote, Virginia Benefits: Caring For Your Family and Your Career...Remote workPermanent employmentFull timeTemporary workShift work
- ...Job Description Are you a registered nurse ready to take your career in an exciting... ...adynamic role focused on advocacy and program integrity through compliance management. Here, you'... ...outcomes for vulnerable populations Remote work - enjoy the convenience and balance...Remote workFull timeTemporary workWork at office
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