Remote Nurse Appeals Specialist
Elevance Health
Elevance Health is looking for a Nurse Appeals Associate to work in a hybrid environment. This role involves researching and resolving administrative appeals, as well as contributing to compliance audits. The ideal candidate must have a current LPN/LVN license and at least one year of relevant experience. The position supports essential quality improvement interventions and enables associates to work with flexibility while promoting productivity. Elevance Health offers a range of competitive benefits. #J-18808-Ljbffr
$90k - $99k
Gainwell Technologies LLC is seeking a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform appeal-related duties, including analyzing... ...including a 401(k) match and health coverage. This is a remote role with up to 25% travel expected. #J-18808-Ljbffr Gainwell...Remote jobFlexible hours- L.A. Care Health Plan is seeking an Appeals and Grievances Nurse Specialist RN II to assist members with health care access and benefit coordination issues... ...and a nursing degree. This position offers a hybrid remote schedule and includes various benefits such as Paid...Remote job
$88.85k
Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:... ...requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in...Remote workFull timeShift workWeekend work- ...Kids for the Future is seeking a DRG Appeals Review Nurse to analyze and appeal denied MS-DRG and APR-DRG accounts. The ideal candidate will have a Registered Nurse License, relevant coding certifications, and extensive clinical experience. Key responsibilities include...Remote workWork from home
- A healthcare solutions firm is looking for a Clinical Appeals Nurse (RN) to support revenue cycle operations by reviewing denied claims. This remote position requires an active RN license and 3-5 years of clinical nursing experience. Responsibilities include assessing...Remote work
- ...Downtown Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform all appeal-related duties, including... ...summaries for hearings. This position is a full-time, permanent remote role that complies with work-from-home policies. The...Remote workPermanent employmentFull timeWork from homeFlexible hours
$68k - $100k
...Impact you will make? The Clinical Nurse Specialist plays a critical role in resolving... ...documentation into clear, evidence-based appeal arguments that drive reimbursement outcomes... ...of confidentiality obligations US remote-based colleagues are not permitted to...Remote workPermanent employmentFull time- ...Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department: Clinical Appeals Reports To: Director of Clinical Appeals Position Overview The Clinical Appeals Nurse supports HBiz’s revenue cycle operations by reviewing denied claims for clinical...Remote work
$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes... ...Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (...Remote workFull timeWork from homeFlexible hours- BlueCross BlueShield of South Carolina is hiring an Appeals Analyst to research and analyze complex appeal requests. This full-time position involves conducting thorough clinical reviews to ensure compliance with medical necessity guidelines. The successful candidate will...Remote jobFull timeWork at officeWork from home
- ...for best heart programs. The Clinical Nurse Specialis t will work alongside the... ...Eligible. Certified Clinical Nursing Specialist in Virginia All Direct Care RN's required... .... For positions that are available as remote work, Sentara Health employs associates...Remote workTemporary workShift work
- Ternium Revenue Cycle Management is seeking a full-time Remote Clinical Review Nurse to analyze denied insurance claims, draft appeal letters, and collaborate with legal teams. The role is crucial for optimizing patient care revenue without direct patient interaction. The...Remote jobFull time
- ...IMCS Group is seeking an experienced nurse for a 10-month contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with company policies. The position allows for remote work, preferably from Iowa, with possible on-site...Remote workContract work
$90k - $99k
A leading healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage in hearings, both... ...have an active RN license and coding certification. This remote role offers flexibility and opportunities for career development...Remote workFlexible hours- ...contract (Possibility to extend) Location: Remote, preferred Iowa. Possible to work on-site... ...received Generate appropriate appeal resolution communication to the member and... ...and assigned by the team lead; the appeals nurse is responsible for working the appeal start...Remote workContract workShift work
$26.22 - $48.71 per hour
Location: Remote. Pay Range: $26.22 - $48.71 Position Summary The RN will be an integral... ...Team and complete patient oral oncolytic appeals on behalf of AON. Key Performance Areas Patient... .../Requirements Education: Registered Nurse (associate’s or bachelor’s degree) Previous...Remote workMonday to Friday- Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with...Remote jobWork from homeFlexible hours
- AlediumHR is looking for experienced Nurse Practitioners with a minimum of 1 year of Hormone Replacement Therapy experience. This role offers remote work flexibility, focusing on hormone optimization and wellness care for both men and women. You will conduct consultations...Remote work
- ...healthcare organization in Lexington is seeking an experienced Appeals Pharmacist to ensure fair access to medications for patients. This... ...skills. The position offers competitive compensation and flexibility, including potential remote options. #J-18808-LjbffrRemote work
- Job Title Bexar County Remote Registered Nurse - Medical Review Specialist About the Role Avosys is a growing integrator of professional, technological and... ...Part B claims for Medical Review, Redeterminations / Appeals, and Prior Authorization requests in accordance with...Remote jobTemporary workFor contractorsWork at officeLocal areaImmediate startShift work
- A managed care organization is seeking an Appeals Pharmacist to review and process medication coverage appeals. This role is ideal for pharmacists with strong clinical judgment and prior experience in managed care. Responsibilities include evaluating clinical documentation...Remote workFlexible hours
- MVP Health Care is seeking a Clinical Appeals RN to ensure fair and timely review of healthcare service denials. This role involves analyzing medical records and clinical documentation and collaborating with medical directors to decide on appeals. The ideal candidate will...Remote job
- ...A healthcare organization is seeking an Appeals Pharmacist in St. Louis, Missouri, to review and process medication coverage appeals.... ...medications. Competitive salary and comprehensive benefits are offered, with potential hybrid or remote work options. #J-18808-Ljbffr...Remote work
- ...confidential managed care organization is seeking an experienced Appeals Pharmacist to ensure fair access to medications for patients.... ...salary, comprehensive benefits, and opportunities for growth, with many positions available as hybrid or fully remote. #J-18808-LjbffrRemote work
- ...Role Snapshot The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services... ..., skills, and experience. Work Location We are open to remote work in the following approved states: Colorado, Florida,...Remote workContract workFor contractorsImmediate start
- ...A confidential managed care organization in Bothell, WA, seeks an experienced Appeals Pharmacist. In this role, you'll review and process medication coverage appeals, ensuring fair access for patients through collaboration with healthcare professionals and by applying...Remote work
- A healthcare organization is looking for an Appeals Pharmacist to ensure fair medication access for patients. You will review and process... ..., and relevant experience. This position may offer hybrid or remote work options along with competitive benefits and salary. #J-188...Remote work
- ...A prominent medical institution in New York seeks a Research Nurse Specialist to perform technical and administrative duties for clinical research... ...is required. The role includes Monday to Friday onsite work with potential for remote work after orientation. #J-18808-Ljbffr...Remote workMonday to Friday
- A confidential managed care organization is seeking an experienced Appeals Pharmacist in Anchorage, Alaska, to advocate for patients and ensure fair medication access. Key responsibilities include reviewing clinical documentation and collaborating with healthcare professionals...Remote work
- ...A confidential managed care organization is seeking an Appeals Pharmacist to review medication coverage appeals. This individual will leverage clinical knowledge to advocate for patients, ensuring fair decisions. Responsibilities include reviewing clinical documentation...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Nurse Appeals Specialist. Be the first to apply!
- remote customer service chat Grand Prairie, TX
- remote coding part time Grand Prairie, TX
- part time remote medical coder Grand Prairie, TX
- remote technician Grand Prairie, TX
- physician consultant remote Grand Prairie, TX
- remote sales consultant Grand Prairie, TX
- entry level finance remote Grand Prairie, TX
- remote internship accounting Grand Prairie, TX
- remote outreach specialist Grand Prairie, TX
- informatica remote Grand Prairie, TX


