Remote Senior Nurse Reviewer: Audit & Appeals
Mass General Brigham Incorporated.
- Remote job
Mass General Brigham Incorporated is looking for a Senior Nurse Reviewer responsible for coordinating clinical charge audits and appeal processes. The role demands strong analytical skills and experience in clinical nursing and quality assurance. This is a remote position requiring effective communication with multidisciplinary teams. The ideal candidate should possess a Bachelor's Degree in Nursing, an MA State RN License, and have experience in appeal writing. #J-18808-Ljbffr Mass General Brigham Incorporated.
- The Nurse Reviewer is responsible for the coordination, facilitation, and appeal of the clinical components of charge audits and forensic review findings. This includes audits conducted at Mass... ...nursing staff. Working schedule Remote, M-F eastern standard business...Remote workSenior
$65k - $88.6k
Humana is seeking a Senior Grievances & Appeals Analyst to analyze and audit complaints, ensuring the integrity of claims and authorization processes. This role involves utilizing data analysis tools and performing root cause analysis of audit findings to recommend improvements...Remote jobSeniorWork from homeFlexible hours$87.12k - $137.21k
Elevance Health is seeking an Audit and Reimbursement Lead - Appeals to provide technical direction and operational support for associates. This virtual role requires extensive experience in audit/reimbursement and in-depth knowledge of CMS principles. Candidates should...Remote jobSenior$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 challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...Remote workFull timeWork from homeRelocation packageFlexible hours$90k - $99k
...candidates. Summary We are seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal related... ...environment. What you should expect in this role Remote (Work from Home) Up to 25% Travel for onsite hearing testimony...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... ...have an active RN license and coding certification. This remote role offers flexibility and opportunities for career development...Remote jobFlexible hours$79.56k - $115.72k
...professionals, including doctors, nurses, business people, tech... .... Job Summary The Senior Nurse Reviewer is responsible for the... ..., facilitation, and appeal of the clinical components of charge audits and forensic review... .... Working schedule: Remote, M-F eastern standard...Remote workSeniorFull timeShift work$90k - $99k
Santa Barbara Cottage Hospital is seeking a DRG Nurse Reviewer Appeals and Hearings. The role involves coordinating and performing all appeal-related... ...5+ years of clinical experience. This position allows remote work with minimal travel and offers a pay range of $90,000 -...Remote jobFlexible hours- ...Shield of CA is seeking a Medicare Appeals RN Senior in Los Angeles, CA. This role involves reviewing member appeals and grievances,... ...holds a Bachelor of Science in Nursing and a current California RN... ...hybrid virtual work, balancing remote responsibilities with in-office...Remote workSeniorWork at office
- A healthcare solutions company seeks a Manager of Clinical Appeals in New York. The role involves overseeing clinical appeals operations... ...clinical appeals and team leadership, particularly in managing remote teams. The position requires strong writing skills and a...Remote workSenior
- Stryker Corporation is seeking a Senior Manager, Quality Assurance and Audit to oversee quality programs within the Grievance & Appeals QA organization. This leadership role ensures operational... ...leading a team of Quality Analysts in a remote environment. A bachelor's degree and...Remote jobSenior
$19 - $29 per hour
...Clinical Coder The Clinical Coder conducts outpatient post-service administrative claims or appeals coverage determinations (such as bundling reviews) for which they are empowered outside of our company's clinical unit manager program requirements. This role applies...Remote workSeniorHourly payApprenticeshipWork from home- Humana is seeking a Senior Grievances & Appeals Analyst/Professional to analyze complaints and ensure claims integrity. You will be part of the... ...data analysis tools like Excel and SQL. This position offers remote work opportunities and a supportive work environment...Remote jobSenior
- BJC HealthCare in St. Louis is seeking a Manager for Appeals, responsible for managing complex healthcare appeals and collaborating with various stakeholders. The role offers a fully remote work environment and a flexible schedule. Candidates should have 5-10 years of...Remote jobSeniorFlexible hours
- 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 jobSeniorFull time
$24.03 - $28.83 per hour
...mental health services Review and reconcile patient... ...billing issues: denials, appeals, discrepancies using... ...Experience working remotely Experience with commercial... ...Friday 9am - 5pm EST Seniority level Mid‑Senior level... ...function Accounting/Auditing and Administrative Hospitals...Remote jobSeniorContract workMonday to FridayShift work- ...Job Description Description: Tax Senior Associate, (Boston, MA, Hoboken, NJ) –... ...office. This position also allows for remote work. Job Responsibilities: Senior Associate... ...and local outsourcing engagements, audits and appeals and provide consulting to Fortune 500 and...Remote workSeniorWork at officeLocal areaImmediate start
- ...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...Remote workSeniorFull time
$120k - $160k
Senior Manager, Property Tax | Lead Multi-State Compliance for Fortune 500 Clients | Remote-Friendly | Growth-Focused Team This Jobot Job is hosted by Eric Kee. Are you a... ...property tax outsourcing engagements, audits, and appeals Oversee timely filing of personal property...Remote workSeniorFull timeLocal area$68.97k - $113.31k
...The Senior RN Clinical Consultant will work in partnership with Clinical and Vocational... ...expert in all lines of business (STD/LTD/Appeals) and products, action planning management... ...leadership as needed Location This is a remote position with occasional travel as needed...Remote workSeniorFull timeVisa sponsorshipWork visaFlexible hours- ...Job Description Job Description Audit Senior - REMOTE OPTIONS AVAILABLE We are currently seeking an Audit Senior with three to five years of public accounting experience. Our Audit Seniors work on audit related projects for both large and small clients in a wide...Remote workSenior
$18.5 - $35.29 per hour
Position Summary Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues... ...special investigations, provider relations, customer service or audit experience. Preferred Qualifications Medicare experience. Claims...Remote jobSeniorHourly payFull timeLocal area$58k - $62k
...Senior Billing Specialist The Senior Billing Specialist is the... ...2 days/week on-site, 3 days remote), giving you concentrated time... ...holds or pending statuses Appeal underpayments and incorrect denials... ...Conduct monthly internal audits: review 15-20 claims for coding...Remote workSeniorTemporary workWork at officeWork from home2 days per week$47 - $56 per hour
Senior Auditor Quality - CCCR Job Locations US-Remote ID 2026-18251 Category Audit - Healthcare Position Type Full-Time... ...independent audit claims review. Displays... ...audit role and/or the appeals role as needed. This... ...Bachelor's degree in Nursing (active /...Remote jobSeniorFull timeWork at officeImmediate startFlexible hours- ...payers in a timely manner. Review medical and care... ...denied claims, and initiate appeals when necessary. Resolve... ...-end reporting and audits as needed. Qualifications... ...independently and as part of a remote or distributed team.... ...results for families. Seniority level Seniority level...Remote workSeniorFull timeWork at office
- ...professionals providing outsourced tax, audit, and accounting services to... ...and nationwide discounts that appeal to a wide array of activities... ...opportunities Flexible, remote-friendly work environment... ...We are seeking an experienced Senior Accountant to support our outsourced...Remote workSeniorFull timeFor contractorsWork at officeLocal areaFlexible hours
$75k - $85k
...forecasting process for assigned properties Review and analyze CAM (Common Area Maintenance)... ...of annual property tax assessments and appeals Coordinate with property managers to... ...Assist with the coordination of audits and tax filings for assigned properties...Remote workSeniorWork at officeLocal area$170k
...Job Description Job Description Senior Audit Manager - East Texas/West Louisiana Hybrid-Remote Flexibility | Base Comp to $170K Average Busy Season under... ...-and-play leadership role buried under layers of review and red tape. Our client, a well-respected CPA...Remote workSenior$110k - $115k
A leading recruitment firm is seeking a Senior Corporate Accountant for a prestigious organization. This role demands strong consolidation... ...ledger, preparing financial statements, and assisting with audits. Ideal candidates will possess excellent organizational capabilities...Remote jobSeniorWork from home- ...Description Job Description Senior Data Center Risk Management... ...safety and risk teams to maintain audit-ready compliance Participate in weekly or bi-weekly risk reviews with general contractors... ...Island / New York Metro / or remote / hybrid if outside the region...Remote workSeniorFor contractorsFor subcontractorImmediate startShift work
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