Remote RN Appeals Analyst - Medicare Medical Review
Southcarolinablues
Southcarolinablues is hiring an Appeals Analyst to join their team in Nashville, Tennessee. This role involves analyzing appeal requests and performing clinical reviews to ensure compliance with medical necessity guidelines. The position offers a full-time schedule and the option to work remotely or on-site. Ideal candidates should have at least two years of clinical experience, a valid RN license, and strong analytical skills. Benefits include health plans, 401(k), paid annual leave, tuition assistance, and wellness programs. #J-18808-Ljbffr
- ...currently hiring for an Appeals Analyst to join BlueCross... ...appeal or retrospective review requests including pre... ...requested services meet medical necessity guidelines.... ...plans, Medicaid members, Medicare beneficiaries,... ...active, unrestricted RN license from the United...Remote workMedicalFull timeFor contractorsCurrently hiringWork at officeLocal areaMonday to Friday
- ...solutions company is seeking an Appeals Nurse to review medical records and claims for... ...and ensure compliance with Medicare guidelines for timely resolutions... ...degree and an active RN license with experience in... ...a salary range of 66-68k, remote work options, and comprehensive...Remote workMedical
- ...company is looking for an Appeals Nurse to examine medical records and claims... ...cases related to Medicare coverage. This role... ...assessing appeal cases, reviewing medical records, and... ...degree and active RN license with at... ...benefits, including remote work options. #J-1...Remote workMedical
- ...company is looking for an Appeals Nurse to examine medical records for first-level appeals. The role includes reviewing denied services and preparing... ...in nursing and an active RN license, along with strong... ...skills. The position offers remote work options, competitive benefits...Remote workMedical
- ...company is looking for an Appeals Nurse to examine medical records and claims... ...Examiners to ensure timely reviews and compliance with Medicare guidelines. The ideal... ...nursing degree, active RN license, and experience... ...include competitive pay, remote work options, and...Remote workMedical
- ...solutions company is seeking an Appeals Nurse to examine medical records and claims information... ...redeterminations are medically reviewed. Candidates should hold an RN license with clinical experience... ...offers competitive pay, remote work options, and comprehensive...Remote workMedical
- ...Job Description Fully remote- Must have state of MI unrestricted RN license. You will perform... ...and retrospective review of inpatient, outpatient,... ...ancillary services to ensure medical necessity, appropriate length... ...level of care, including appeal requests initiated by...Remote workMedicalWork at officeFlexible hours
- ...solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. The RN works closely with Appeals... ...timely and medically reviewed redeterminations. The role... ...strong communication skills. Remote work options are available...Remote workMedical
- ...solutions company is seeking an Appeals Nurse to review medical records and claims for... ...ensure that services meet Medicare coverage guidelines while collaborating... ...should hold an active RN license and possess strong... ...skills. Benefits include remote work options, health...Remote workMedical
- ...solutions company is seeking an Appeals Nurse to examine medical records and claims for first... ...degree and an active RN license, with at least one year... ..., conducting medical record reviews, and ensuring compliance with Medicare guidelines. Remote work is available with excellent...Remote workMedical
- ...Tennessee is hiring an Appeals & Grievance Nurse Analyst. This remote position involves reviewing appeals from members,... ...with CMS and Medicare guidelines. The ideal... ...experience and a valid RN license in Tennessee.... ...responsibilities include evaluating medical documentation,...Remote workMedicalWork at office
$70k - $85k
...Medical Review Nurse Analyst Our Medical Review Nurse Analyst - Registered Nurse (RN) is responsible for reviewing medical... ...to authorizations, appeals, and medical review... ...Location: We are open to remote work in the... ...beneficiaries of the Medicare program and manage...Remote workMedicalContract workFor contractorsWork at officeLocal areaImmediate start$66k - $68k
...solutions company is seeking an Appeals Nurse to examine medical records for first-level... ..., ensuring services meet Medicare guidelines. The ideal candidate... ...nursing degree and active RN license, with prior... ...experience considered an asset. Remote work options are available,...Remote workMedical$66k - $68k
...WPS—A health solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. This role requires... ...salary range of $66,000–$68,000 depending on experience, with remote work options available in several states. Excellent...Remote workMedical- ...solutions company is seeking an Appeals Nurse to examine medical records and claims for first-... ...role significantly impacts Medicare coverage decisions and... ...a nursing degree, an active RN license, and strong communication skills. Remote work opportunities are available...Remote workMedical
$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 workMedical- ...Inc. is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals and validating claims to ensure... ...including utilization review, and a valid RN license in Florida or Kentucky....Remote jobMedicalFull time
$36 per hour
...Title: Medicare Advantage RN Review Analyst Location: Detroit, MI (Remote - Must be local to Michigan) Duration: 12+ Months Role Type: W2 Contract role Max Pay Rate... ...B experience a plus. Expertise in the use of medical terminology. Finely honed critical thinking skills...Remote workMedicalContract workLocal areaMonday to Friday- ...healthcare services firm based in the US is seeking a remote Medical Claim Review Nurse. In this role, you will conduct clinical... ...have a minimum of 3 years of experience in clinical appeals review and an active RN license. This full-time position offers a structured...Remote workMedicalFull time
- ...knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of... ..., and concurrent review of appeals for denied prior authorizations. Includes... ...education and experience. Registered Nurse (RN). License must be active and...Remote jobMedicalWork at office
$80k - $90k
...*** Performs clinical reviews on medical records to maintain subject... ...expertise.* Conducts Appeals reviews on medical... ...and/or claims software analyst experience may be... ...work independently in remote setting with minimum supervision... ...* Active unrestricted RN license #J-18808-...Remote workMedicalFlexible hours- ...Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform... ...This position is a full-time, permanent remote role that complies with work-from-home... ...should have at least 5 years of clinical or medical record coding experience, strong...Remote workMedicalPermanent employmentFull timeWork from homeFlexible hours
$90k - $99k
...It takes great medical minds to create powerful solutions that solve... ...individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and... ...required CEUs to maintain RN license and/or coding certification... ...should expect in this role Remote (Work from Home) Up to 25%...Remote workMedicalFull timeWork from homeRelocation packageFlexible hours- Job Posting Title RN Appeals Analyst Medicare Part B - CGS Life insurance, paid holidays, tuition assistance... ...of complex appeal or retrospective review requests including pre-pay and post-... ...if the requested services meet medical necessity guidelines. Lastly, you will...MedicalFull timeFor contractorsCurrently hiringWork at officeLocal areaMonday to Friday
$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work... ...(Exception only) It takes great medical minds to create powerful solutions that... ...completes required CEUs to maintain RN license and/or coding certification....Remote workMedicalFull timeWork from homeFlexible hours- ...Strategic Staffing Solutions is seeking a Medicare Advantage RN Review Analyst based in Detroit, MI. This 12+ month W2 contract role requires a current... ...of Medicare regulations. This position offers a remote work option but must be located in Michigan. #J-18808-Ljbffr...Remote workContract work
- ...TMF Health Quality Institute is seeking a qualified individual for a remote position focused on Medicare appeals. The role entails reviewing medical records, ensuring fair decision-making based on regulations, and addressing beneficiary and provider concerns. Candidates...Remote workMedical
- ...Health Quality Institute offers a full-time remote position focusing on medical dispute resolution. The role involves reviewing patient appeals and making independent determinations... ...of three years in dispute resolution or Medicare appeals. Benefits include medical,...Remote workMedicalFull time
- ...Remote Nurse Position in Michigan This position will be a remote... ...Michigan. Should have a valid MI RN License. Should have... ...experience completing post-acute reviews for the inpatient rehab, skilled... ...Clinical experience in ICU, ER, or medical surgical unit preferred....Remote workMedical
$24 - $30 per hour
...opportunity available as a Managed Care Appeals Analyst . This position will be located remote based. The full time schedule for... ...Perform daily, systematic reviews of $0 balance accounts for the... ...claims data applying knowledge of medical policy such as NCCI and MUE edits...Remote workMedicalHourly payFull timeContract workWork experience placementMonday to FridayShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Appeals Analyst - Medicare Medical Review. Be the first to apply!
- prn registered nurse Nashville, TN
- pediatric rn Nashville, TN
- home health rn Nashville, TN
- nurse rn Nashville, TN
- med surg medical surgical rn registered nurse Nashville, TN
- ob gyn rn Nashville, TN
- cath-lab rn Nashville, TN
- non clinical rn Nashville, TN
- registered nurse pharmacy Nashville, TN
- rn network Nashville, TN


