Remote DRG Nurse Reviewer & Appeals Specialist
$90k - $99kSanta Barbara Cottage Hospital
- Remote job
Santa Barbara Cottage Hospital is seeking a DRG Nurse Reviewer Appeals and Hearings. The role involves coordinating and performing all appeal-related duties, reviewing documentation, and actively participating in hearings. Candidates should have an active RN license, certifications like CPC, and ideally 5+ years of clinical experience. This position allows remote work with minimal travel and offers a pay range of $90,000 - $99,000 annually, plus flexible benefits including a vacation policy and health benefits. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex... ...Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA...Remote workFull timeWork from homeRelocation packageFlexible hours$90k - $99k
...seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform... ...Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional... ...What you should expect in this role Remote (Work from Home) Up to 25% Travel...Remote workFull timeWork from homeRelocation packageFlexible hours$90k - $99k
A leading healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage in hearings, both... ...must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career...Remote jobFlexible hours- ...classified as hybrid, onsite or remote. While the majority of... ...member and provider appeals, grievances,... ...healthcare field of study or Nursing Diploma (Applies to All... ...analysis, clinical review and resolution of provider... ...9, ICD-10, HCPCS, and DRG coding Preferred Professional...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
- The Nurse Reviewer is responsible for the coordination, facilitation, and appeal of the clinical components of charge audits and forensic review findings. This includes... ...training for nursing staff. Working schedule Remote, M-F eastern standard business hours. Requires...Remote work
$24.36 per hour
...The Denials and Coding Specialist - DRG Hospital Inpatient... ...Bellin regions. This role reviews inpatient medical... ...coding accuracy, supports appeal processes, and ensures... ...hours weekly), Full-time Remote eligible after first... ...access hospitals; nursing homes; behavioral health...Remote workFull timeLocal areaWork from homeMonday to FridayShift workDay shift- ...Clinical Documentation Integrity DRG Downgrade Specialist in Parsippany-Troy Hills, NJ. The role involves reviewing payer DRG downgrade... ...reviews, and writing persuasive appeal letters to ensure accurate DRG... ...have a Bachelor's degree in Nursing, a minimum of 3 years in...
$19 per hour
...as our trusted private equity sponsor. We are seeking an Appeals Specialist to join our growing team. As an Appeals Specialist, you will... ...job successfully and independently. Key Responsibilities Review/work denials from an explanation of benefits (EOB) statement...Remote workHourly payFull timeWork at officeWork from home- ...areas of reimbursement. From challenging denials and zero balance reviews to aged accounts receivable, motor vehicle accident claims,... ...patient accounting systems (EPIC, Meditech, Cerner, Athena) Draft appeals to insurance carriers on denied or underpaid claims Review...Remote workPermanent employmentWork from homeFlexible hours
$74.8k - $78.7k
...Nebraska); Work from Home Work Arrangement: Remote : Work at home employee residing... ...Requisition #: 76084 The Role at a Glance As an Appeals Specialist you will be responsible for being a... ...expert to provide full, fair appeal reviews for multiple product lines. You will perform...Remote workContract workTemporary workWork experience placementWork at officeWork from homeRelocation package- ...Member Complaint Resolution Specialist This position is for five locations. Candidates... ...required. This role is responsible for reviewing and resolving member and provider complaints... ...research and resolution of the appeals, dispute, grievances, and/or complaints...Remote workContract workLive inMonday to Friday
$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- ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities... ...insurance plan. Gather updated appeal or review forms to add to form library. Create appeal...Remote workFull time
$14.9 - $29.06 per hour
...Description Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating... ...(CMS). Responsibilities Enters denials and requests for appeals into information system and prepares documentation for further...Remote jobHourly payWork experience placementWork at officeWeekend work$27.74 - $39.16 per hour
...Job Summary The Coding Denial and Appeals Specialist is responsible for ensuring that workflows... ...requirements. This role focuses on reviewing and resolving clinical and medical-necessity... ...Monday-Friday Business Hours Remote work setting, but must live in the state...Remote workHourly payFull timeLive inMonday to FridayFlexible hoursShift work- ...Member Appeals Specialist The role we are looking to fill would be focused on handling standard... ...necessary for the case at hand Reviewing the appeal request to determine if additional... ...(Specialists, Supervisor, Quality Nurses, Medical Directors, Pharmacy Team) Drafting...Remote workTraineeship
- A healthcare technology company is seeking a DRG Integrity Specialist for a full-time remote position. This role involves reviewing medical records and code assignments in accordance with federal guidelines, ensuring accurate DRG assignment. The ideal candidate should...Remote jobFull time
- ...Specialist, Appeals Claims As an Appeals Specialist you will be responsible for being a product subject matter expert to provide full, fair appeal reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously...Remote workContract workTemporary workWork experience placementWork at office
- A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of experience...Remote job
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote jobHourly payWork at office- Healthcare Legal Solutions, LLC is seeking a detail-oriented Revenue Cycle/Follow Up Specialist to manage unpaid claims and appeals in a remote setting. Ideal candidates should be organized, assertive, and interested in healthcare law, ensuring prompt payments and maintaining...Remote jobFull timeWork at office
- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage... ...processing, and excellent analytical and communication skills. Remote work options are available along with competitive benefits...Remote job
- Aspirion in Delray Beach, Florida, is looking for a Denials Appeals Specialist to analyze and submit appeals for denied claims. The role supports... ...bachelor’s degree preferred. The position involves working remotely and understanding healthcare operations. #J-18808-Ljbffr...Remote job
- ...a Technical Denials Management Specialist II within its Revenue Cycle Department. This role focuses on reviewing, researching, and resolving claim denials and appeals across various insurance companies... ...offers flexibility with remote work opportunities but requires...Remote job
$19 per hour
A leading healthcare services provider is looking for an Appeals Specialist to join their team in California. Responsible for reviewing denials, submitting appeals, and maintaining communication with insurance companies, the ideal candidate will have at least 2 years of...Remote jobHourly pay- ...BlueShield of South Carolina is seeking an Appeals Specialist based in Nashville, TN, for a role that includes performing non-medical reviews and processing redetermination letters.... ...position offers the flexibility to work remotely, ensuring accurate documentation and...Remote jobWork at office
- L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider complaints, ensuring compliance with various health regulations, and preparing reports. Requirements include at least 2 years...Remote jobFull time
- CGS Administrators LLC is hiring an Appeals Specialist in Nashville, TN. The role involves performing non-medical reviews, processing redetermination letters, and preparing documentation for legal inquiries. Candidates should have a High School Diploma and 2 years of relevant...Remote jobWork at office
- Join BlueCross BlueShield of South Carolina as an Appeals Specialist and engage in non-medical reviews and processing redetermination letters. This role offers flexibility with fully remote options and a supportive team environment. Candidates should have a High School...Remote jobSecond jobWork at office
- ...to follow up with insurance payers on outstanding claims. This remote position requires 3-5 years of experience in a hospital business office. Responsibilities include documenting claims, writing appeals, and working independently in a fast-paced environment. Candidates...Remote jobWork at office
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