Remote RN Medical Claims Auditor
Machinify Inc.
- Remote job
Machinify Inc. is seeking a Medical Review Nurse for remote work in the US. You will be part of a dynamic team, performing audits on medical claims, ensuring adherence to guidelines, and collaborating with other auditors. An associate or bachelor's nursing degree and experience in auditing or clinical documentation is required. Ideal candidates will have strong coding knowledge and excellent communication skills to document findings effectively. Machinify offers a commitment to equal opportunity and a supportive work environment. #J-18808-Ljbffr Machinify Inc.
- ...Related Group Clinical Validation Auditor-RN. The role involves auditing inpatient medical records, ensuring compliance with... ...experience in coding and claims auditing. This position offers competitive... ...and benefits with flexible remote work options. #J-18808-Ljbffr Elevance...Remote jobMedicalClaimsFlexible hours
- ...Job Title: Clinical Nurse Auditor – Payment Integrity Job Summary... ...your clinical expertise, medical coding proficiency, and auditing... .... You will conduct prepayment claims reviews, post-payment audits,... ...requires a Registered Nurse (RN) with coding certifications...Remote workMedicalClaimsFull timeWork at office
- ...oriented Registered Nurse Clinical Auditor to support medical record reviews and billing... ...The ideal candidate should have an RN license, coding certification, and at least 1 year of Medicaid claims review experience. This remote position requires occasional travel...Remote jobMedicalClaims
$70k - $80k
A data analytics and solutions company is seeking a Clinical Validation Auditor to ensure accuracy in medical claims coding. This fully remote position requires a Registered Nurse with over 5 years of acute care experience. Responsibilities include reviewing medical records...Remote jobMedicalClaims- ...looking for a Diagnosis Related Group Clinical Validation Auditor‑RN to audit inpatient medical records and ensure compliance with coding and... ...substantial experience in clinical documentation improvement and claims auditing. The position comes with a comprehensive benefits...Remote jobMedicalClaimsFull time
- ...Medical Review Clinical Appeals Auditor (RN) In October 2025, Machinify acquired Performant and we are now part... ...documentation and conducts research, analyzes claims data, applies knowledge of client... ...ability to work independently in remote setting with minimum supervision...Remote workMedicalClaimsFlexible hours
- ...located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring compliance with company... ...guidelines. This role requires an active RN license and the ability to analyze claims data and regulations effectively. The...Remote jobMedicalClaims
- RN Inpatient Hospital Auditor - Remote (New Jersey) - 6‑month contract, 3+ years experience - Start date: ASAP... ...minimum of 3 years experience in a medical records department of an acute care... ...and coordinates referral of improper claim payments through the appropriate channels...Remote jobMedicalClaimsWeekly payDaily paidContract workLocal areaImmediate start
$34.23 - $61.15 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS... ...in the auditing of inpatient claims. Employing both industry and... ...review to ensure accuracy of medical coding and utilize clinical... ...Ability to work independently in a remote environment and deliver...Remote workMedicalClaimsHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaRelocation package- ...Description The Denials Nurse Auditor works under the supervision of... ...and skills in areas of: Medical Necessity, Authorizations, Experimental... ...review of appropriate post-claim denials; prepares clinical... ...~ Registered Nurse (RN) - State Licensure/Or Compact...Remote workMedicalClaimsWork experience placementWork at officeLocal area
$78.5k - $90k
...8,500 - 90,000 The Medical Review Nurse - Home Health... ...performs medical claims audit reviews on Home Health... ...of experienced medical auditors and coders performing... ...Payers. You will work remotely in a fast paced and dynamic... ...Active unrestricted RN license in good standing...Remote workMedicalClaimsFor contractorsWork at officeWork from homeHome officeShift work$85k - $90k
...parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments... ...to support findings Qualifications An active RN professional license in good standing Clinical...Remote jobMedicalClaimsWork at office$113.77k - $215.57k
...Diagnosis Related Group Coding Auditor Principal - Carelon Payment... ...will work in a hybrid model (remote and office). The ideal candidate... ...eliminate, and prevent unnecessary medical-expense spending. The DRG... ...inpatient medical records on claims paid based on Diagnostic Relation...Remote workMedicalClaimsDaily paidWork at officeLocal area1 day per week- ...Wellness resources Summary: A Hospital Claims Auditor is responsible for the overall quality... ...plan contracting, delineation of risk, medical terminology and standard industry... ...perform independently according to departmental standards. This is a remote position....Remote workMedicalClaimsContract work
- Valenz is seeking a Certified Medical Coding Auditor (Clinical Bill Review Analyst) to identify billing discrepancies... ...include reviewing medical bills, analyzing claims, and collaborating with the Negotiation team. This fully remote position offers extensive benefits and an...Remote jobMedicalClaims
- ...Must have an active unrestricted RN license in the state of South Carolina... ...for training then will be fully remote Description - Reviews and evaluates medical or behavioral eligibility... ...Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive...Remote jobMedicalClaimsContract workLive in
- ...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 jobMedicalClaims
- Santa Barbara Cottage Hospital seeks a Complex Claims Clinical Reviewer for a remote position. Responsibilities include conducting prepayment and post... ...generating decision action notices, and ensuring compliance with medical reimbursement guidelines. Ideal candidates will have a...Remote jobMedicalClaimsWork from home
- Feitong Buke is looking for a Medical Coding Auditor for a remote position. The role focuses on ensuring the accuracy of medical coding on claims, enhancing payment precision, and contributing to quality improvement initiatives. Candidates should have relevant certifications...Remote jobMedicalClaimsFlexible hours
$90k - $115k
...The ideal candidate will possess a nursing degree or equivalent, with at least two years of inpatient claims auditing experience. Responsibilities include auditing medical records, providing clinical support, and ensuring compliance with regulations. The job offers a...Remote jobMedicalClaimsFlexible hours$65.41k - $85.85k
...Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar... ...recoup inappropriately paid claims. The Specialist Investigation... ...Work Location: This is a remote position, open to candidates who... ...Perform complex audits of assigned medical records and claims on both a...Remote workMedicalClaimsFull timeWork experience placementWork from homeHome office$70k - $90k
...Stop Loss Claims Analyst As a Stop Loss Claims Analyst (aka Auditor), you'll perform quality review and evaluation of all... ...This position can either be fully remote (if not within a commutable... ...appropriate contractual provisions to the medical facts and specifications of the...Remote workMedicalClaimsFull timeWork at office- ...Position Overview: We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement...Remote workMedicalClaimsWork at office
- ...Fraud, Waste, and Abuse Auditor Under the general direction of the Associate Director... ...practices, including data mining, claims analysis, and medical record assessment. Onsite... ...month, all other aspects of the job are remote. Responsibilities Ensure compliance...Remote workMedicalClaimsWork at office
- ...seeking a Senior Specialist, Coding Auditor to join their Payment Integrity team. This remote position involves supporting issue resolution, ensuring claims repayment quality, and assisting in... ...comprehensive benefits including medical, dental, and unlimited vacation. #J...Remote jobMedicalClaims
- Cotiviti, Inc. is seeking a full-time State Licensed Senior Auditor to support the Clinical Chart Validation team. In this remote role, you will defend recovery determinations by reviewing claims and applying relevant guidelines. The ideal candidate will possess an Associates...Remote jobMedicalClaimsFull time
$42 - $44 per hour
...Job Description Job Title: Hybrid RN Case Manager Remote with Face to Face visits in homes, hospitals... ...with members to evaluate the medical needs of the member to facilitate the... ...impact functionality. Reviews prior claims to address potential impact on current...Remote workMedicalClaimsHourly payWeekly payTemporary workMonday to Friday- A leading healthcare services firm is seeking an experienced Inpatient Medical Coding Auditor to extract clinical information and assign medical codes for inpatient hospital claims. This remote role involves reviewing claims for reimbursement accuracy and handling provider...Remote jobMedicalClaims
- ...divh2Program Integrity Medical Coding Reviewer III/h2pThe Program Integrity Medical Coding Reviewer III generates comprehensive and concise... ...strong relationships with cross-departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal...Remote jobMedicalClaims
- MedPOINT Management is seeking a Hospital Claims Auditor responsible for ensuring the quality of claims processes and... ...analytical, and communication abilities, along with expertise in medical coding and contracting. This is a remote position. #J-18808-Ljbffr MedPOINT ManagementRemote jobMedicalClaims
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