Remote RN: Clinical Appeals & IDR Reviewer (NY/EST)
Medix
Medix™ is seeking a Clinical Review RN for a remote role that supports Independent Dispute Resolution (IDR) case determinations. Candidates must have at least 2 years of clinical experience and a BSN along with a New York State RN license. The position operates on EST hours with flexibility in start times. The Clinical Review RN will conduct clinical reviews, provide training for new RNs, and assist staff in problem solving and decision-making. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote RN: Clinical Appeals & IDR Reviewer (NY/EST) in Jericho, NY vacancy
$50 per hour
Overview Registered Nurse Clinical Reviewer / IDR - Remote to Office-Based, Jericho, NY (ID #25302) Location: Remote to Office... ...-legal reviews, research, and appeals while ensuring regulatory compliance... ...or a graduate of an approved RN program Licensure: Current New...Remote workHourly payFull timePrivate practiceWork at officeFlexible hours$50 per hour
...Overview RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr Position Overview Greenlife... ...include conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization. Why Join Us?...Remote workHourly payFull timeWork at officeFlexible hoursSanta Barbara Cottage Hospital
New York, NY1 day ago$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances... ...schedules: EST Schedule: Wednesday through... ...and prepare cases for review and appeals. Minimum... ...: Greater NYC Area (NY, NJ, CT): $81,099 - $...Remote jobFull timeMonday to FridayShift work$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&... ...or delivery of clinical and non-clinical... ...is 100% Remote. We are hiring for... ...schedules listed below: EST Schedule... ...Medical Director Review ensuring that all... ...: RN, LPN OR Dental Hygienist... ...York City Area (NY, NJ, CT residents...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- ...Medix™ is seeking a dedicated Appeals Nurse (RN) to join our team in a fully remote capacity. This role involves clinical reviews and appeal determinations while collaborating with Medical Review Analysts and Physician Consultants to ensure compliant outcomes. The ideal...Remote work
Medix
New York, NY4 hours ago - ...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...Remote work
MVP Health Care
Schenectady, NY3 days ago - ...UnitedHealth Group is seeking a Senior Clinical Appeals RN to utilize expertise in MS-DRG and APR-DRG auditing to manage appeals. This position allows remote work throughout the U.S., except for Minneapolis or Washington, D.C. hires, who need to work in-office at least...Remote workWork at office
Registered Nurse
Minneapolis, MN4 hours ago $35 - $63 per hour
...University of Minnesota School of Nursing is looking for a Senior Clinical Appeals RN. This role involves reviewing and responding to appeals in MS-DRG and APR-DRG auditing and provides coaching to remote specialists. Remote work is available within the U.S., but...Remote workHourly payWork at officeUniversity of Minnesota School of Nursing
Minneapolis, MN4 hours ago$35 - $63 per hour
...Texas Health Institute is looking for a Senior Clinical Appeals RN to utilize expertise in MS‑DRG and APR‑DRG auditing. This role involves reviewing medical records and responding to appeals while providing coaching to remote DRG Validation Specialists. The position...Remote workHourly payWork at officeTexas Health Institute
Minneapolis, MN4 hours ago$35 - $63 per hour
...Territorial Epidemiologists is hiring a Senior Clinical Appeals RN. This position utilizes expertise in MS-DRG and APR-DRG auditing to review appeals and is responsible for analyzing... ...in ICD-10 coding. The role allows for remote work, and candidates should be solution-...Remote workHourly payCouncil Of State and Territorial Epidemiologists
Minneapolis, MN4 hours ago$35 - $63 per hour
...Stryker Corporation is seeking a Senior Clinical Appeals RN to utilize clinical expertise in appealing and coding medical records. The role... ...have at least 2 years of coding experience with ICD-10. Remote work opportunities are available in the U.S., and the position...Remote workHourly payStryker
Minneapolis, MN4 hours ago$35 - $63 per hour
...Optum is seeking a Senior Clinical Appeals RN to utilize expertise in MS-DRG and APR-DRG auditing for appeals management. This role involves... ...auditors, and authoring rebuttals. The job can be performed remotely across the U.S., with certain locations requiring in-office...Remote workHourly payWork at officeOptum
New York, NY4 hours ago$50 per hour
...A leading healthcare staffing firm is seeking an experienced RN Clinical Reviewer to work remotely. You'll conduct detailed medical-legal reviews and appeals while maintaining high accuracy and integrity. Key qualifications include a New York State RN license and at least...Remote workSanta Barbara Cottage Hospital
New York, NY1 day ago$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals) Experience: Open to various clinical backgrounds/experience. Appeals... ...State RN license*** Location: Remote (can sit anywhere in the US as long as you can work EST hours) Hours of Operation: M-F 7a-...Remote workLocal areaImmediate startFlexible hoursMedix
Jericho, NY6 days ago$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider appeals. Candidates must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience...Remote workFull timeContract workMonday to FridayPiper Companies
Cary, NC2 days ago$50 per hour
...recruitment agency is seeking a Registered Nurse Clinical Reviewer for a remote to office-based position in Jericho, NY. This role involves conducting medical-legal reviews... ...baccalaureate degree in Nursing and a current NY RN license with at least 3 years of related...Remote jobWork at office$35 - $63 per hour
...experienced healthcare coder to analyze DRG Appeals, prepare written appeals, and... ...The role requires an unrestricted RN license and extensive knowledge of ICD-10 coding as well as clinical judgment. Enjoy the flexibility to work remotely from anywhere in the U.S., with...Remote jobHourly payWork at officeLocal area$80k - $90k
...OPPORTUNITY: Expected Hiring Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting Appeals reviews of new... ...Self-starter with the ability to work independently in remote setting with minimum supervision and direction in the...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift workThe Rawlings Group
Plantation, FL4 days ago$71.59k - $116.48k
...prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case... .... The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job$53.38 - $80.08 per hour
...RN Clinical Document Integrity Specialist PeaceHealth is seeking a full time RN Clinical Document Integrity Specialist. This remote role requires the incumbent to reside & work in OR, WA, or AK... ...to support data integrity. Reviews clinical documentation, identifies...Remote workFull timeWork experience placementWork at office$45.29 - $84.11 per hour
...for the better. Hybrid/Remote Summary: The... ...providing timely and accurate clinical information to all... ...Responsibilities: # Review all inpatient admission... ...Tracking and trending all appeals and communicating on a... ...field Required: Current RN License in Connecticut...Remote workHourly payDaily paidPart timeShift workNight shiftRotating shiftNorthwell Health
Danbury, CT15 hours ago- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In this vital role, you will conduct clinical reviews ensuring compliance with Medicare guidelines... ...requires current RN licensure in NY & VT and a solid background in...Remote work
MVP Health Care
New York, NY3 days ago $69.38k - $92.28k
Overview As a Clinical Appeals RN, you will review denied service authorizations and claims, evaluate medical necessity, and work closely with Medical... ...Hybrid - work performed in a combination of office and remote settings. EEO Statement MVP is an equal opportunity employer...Remote workWork at office- ...located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records,... ...guidelines. This role requires an active RN license and the ability to analyze... ...and reporting within the appeals process, contributing to continuous...Remote job
$35 - $63 per hour
...and resolution of DRG Appeals Respond to Level one,... ...adjustment is needed Review governmental regulations... ...written appeals Exercise clinical and/or coding judgment... ...Qualifications: Unrestricted RN (registered nurse)... ...flexibility to work remotely from anywhere within the...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal area- A healthcare review company is seeking a Physician Reviewer to work telecommuting. This role utilizes clinical expertise to review insurance appeals and claims. Candidates must possess an active NM License and have a solid understanding of evidence-based guidelines. Responsibilities...Remote workFor contractors
Dane Street
Santa Fe, NM4 days ago - ...Elevance Health is seeking a Nurse Appeals - Licensed Nurse to work... .... The role requires a current RN license and a minimum of two years... .... Candidates must have strong clinical experience and leadership... ...business hours from 8 am to 8 pm EST. Elevance Health promotes a...Remote workShift work
Elevance Health
Indianapolis, IN4 hours ago $60 per hour
A healthcare staffing organization in Jericho, NY is seeking a Full-time Registered Nurse Clinical Reviewer. This role requires a Baccalaureate degree in Nursing... ...1-3 years of experience in utilization review or appeals and strong communication skills, contributing to patient...Hourly payFull time- ...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... ...interaction. The ideal candidate will have an RN License and over 5 years of acute hospital experience...Remote workFull time
Ternium Revenue Cycle Management
New York, NY1 day ago - ...Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department: Clinical Appeals Reports To: Director of Clinical Appeals Position Overview... ...Nurse supports HBiz’s revenue cycle operations by reviewing denied claims for clinical accuracy and medical...Remote work
Health Business Solutions
Florida, NY3 days ago
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