Remote RN: Clinical Finance & Denial Management
Ohio State University
- Remote job
The Ohio State University Wexner Medical Center is seeking a Clinical Finance Case Manager - RN to secure complex pre-authorizations and prevent denials. You will apply clinical knowledge to determine appropriate care levels and read payer guidelines across state and national requirements. Join a multidisciplinary team and become a SME for assigned payers, with responsibilities spanning Appeals, Utilization Management, and collaboration with Legal and Medical Information Management. #J-18808-Ljbffr Ohio State University
- Ohio State University Wexner Medical Center seeks a Clinical Financial Case Manager - RN to implement and support clinical denials prevention, pre-authorizations, and appropriate care level determinations. You will become SME for assigned payers and governmental audits...Remote job
- ...Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area... ...Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA)... ...licensed denial unit staff, managing daily tasks, performance reviews... ...Nursing Program; RN preferred. Minimum of five...Remote workPermanent employmentTemporary work
- CVS Health is seeking a Clinical Quality & Compliance RN for a remote role focused on quality, compliance, and operational excellence. You will ensure utilization management processes meet regulatory, accreditation, and quality standards, supporting audits and regulatory...Remote job
- UT Southwestern Medical Center seeks a Clinical Denial Management Specialist III to perform advanced medical billing/denial duties under supervision... ...and EPIC familiarity. CPC certification is a plus. 100% remote work with a shift Mon-Fri; benefits include comprehensive healthcare...Remote jobShift work
- A prominent medical institution in Columbus, Ohio is seeking a Clinical Financial Case Management - RN Specialist 2. This role involves implementing clinical pre-certification, managing denials, and supporting patient care teams. Candidates must possess a Bachelor's degree...SuggestedFull timeDay shift
- UT Southwestern Medical Center in Dallas, TX invites applications for a Clinical Denial Management Specialist III in the Revenue Cycle Department. This is a 100% work-from-home role with a Monday-Friday, 8-hour shift; preference given to candidates near the DFW area, interview...Remote jobWork from homeMonday to FridayShift work
- ...Ensures completion of appropriate clinical review of all applicable... ...stated in system utilization management plan. Oversees Clinical Review... ...week. This role will be remote BUT regular meetings/trainings... ...utilization review process, aids in denial prevention, and serves as...Remote workReliefWeekend work3 days per week
- Inova Health System is seeking a Registered Nurse (RN) for Clinical Denials and Appeals. This full-time remote role supports denials and appeals across facilities, with start times between 7:30 AM-9:00 AM ET. The role requires a bachelor’s or associate degree with RN license...Remote jobFull time
- Inova Health System is seeking a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team as a Full-Time Remote role. The position supports review of denied claims, development and submission of timely appeals, and collaboration across UR, Coding, Billing...Remote jobFull time
- Inova Health System is seeking a dedicated Registered Nurse (RN) for Clinical Denials and Appeals. This is a Full-Time Remote role, Monday-Friday, with start between 7:30 AM-9:00 AM ET. The position supports appeals and coordination across UR, PFS, Coding, Billing, and...Remote jobFull timeMonday to Friday
- Inova Health in Fairfax, VA (Inova 8095 - Fairfax East) seeks a dedicated Registered Nurse (RN) for Clinical Denials and Appeals. This full-time remote role offers a Monday-Friday schedule with start between 7:30 and 9:00 AM ET, providing opportunities to impact payer disputes...Remote jobFull timeMonday to Friday
$80k
...-enabled revenue cycle management solutions for health systems... ...for any patient clinical condition or procedure... ...assignment. Reviews DRG denial letters and writes denial... ...Minimum Education:Current RN LicensureCertifications... ...Top Workplace for Remote Work 2024Great Place to...Remote workLocal area- Abacus Insights is seeking a Complex Clinical Audit (CCA) Business Solutions Lead with 5+ years in payment integrity to translate payer needs into scalable product logic. You’ll work with AI Engineering on backend build, demo capabilities to major payers, and shape how...Remote job
- Job Title: Clinical Financial Case Mgr - RN Department: Health System Shared... ...and Revenue Cycle Management Shared Services... ...clinical appeals and denial management. RCCS is... ...Compliance, Legal, Finance, Transplant workflows... ...Information Location: Remote Location Position Type...Remote workFlexible hoursShift workDay shift
$62.5k - $79.8k
...technology-enabled revenue cycle management solutions for health systems, including... ...0.00/ based on experience The Denials RN Coordinator prepares appeals for clinical and technical claim denials... ...application of AI. This is a remote position; however, candidates must...Remote workFull timeContract workTemporary workWork at officeLocal area- Montefiore Medical Center is seeking a Clinical Appeals Manager to lead the Wakefield Division's appeals process. You will respond to third-party denials, interface with health plans and coordinate with Finance and Contracting on utilization-management issues. In this role...
- Registered Nurse (RN) Clinical Denials and Appeals United States Job Description Inova 8095 - Fairfax East is looking for a dedicated Registered... ...and Appeals to join the team. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start Time to be between 7...Remote workFull timeMonday to FridayFlexible hours
- ...Registered Nurse to join our team as Clinical Quality Assurance Coordinator. This 100% remote role focuses on peer review... ...ideal candidate holds an active RN license, 2+ years of clinical experience... ...strong communication and time management skills. #J-18808-Ljbffr MES...Remote jobWork from home
- ...Registered Nurse for an outpatient Pacemaker/Device Clinic. You will perform in-clinic and remote device checks and support device management for pacemakers, ICDs, and CRT devices. You... ...and timely follow-ups. A BSN/ADN and IL RN license are required, with 1-2 years of...Remote work
$38.22 - $57.33 per hour
...Location: South University Clinic Department: 3021120 GENERAL... ...Fargo, North Dakota. This RN is salaried and works 8 am to... ...of the patient/family’s self-management skills. Supports continuous quality... ...FTE: 0.6 Possible Remote/Hybrid Option: Shift Rotation...Remote workTemporary workPart timeCasual workWork from homeFlexible hoursShift workWeekend work3 days per week$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing... ...applications This is a 100% remote role, and requires robust internet...Remote workFull timeFlexible hoursShift work- Molina Healthcare is seeking an RN with a US license in good standing to join the Medicaid Team as a Clinical Auditor. The role may offer remote work flexibility, but the candidate must reside in Michigan and operate within Michigan-based guidelines. The incumbent will...Remote job
- Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records, ensuring clinical documentation supports DRGs billed and reimbursed. The role emphasizes ICD-10 coding expertise and DRG validation across multiple DRG...Remote job
$90k - $104.84k
...RN, DRG Coder / Clinical Auditor Must be a Registered Nurse with experience Remote | Full-Time | Healthcare | Clinical Documentation & Coding About the Role We’re seeking... ...workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed...Remote workFull timeWork at office- Infinity Hospice Care LLC in Florida is seeking a Clinical Care Manager (RN or LPN) to serve as the clinical point of contact for a home care caseload. The role blends nursing judgment with care coordination, acting as triage for medical concerns and caregiver issues, often...Remote job
- Sagility is seeking a Clinical Operations Supervisor to lead a team of telephonic... ..., quality, and compliance in a remote setting. The ideal candidate will have RN licensure, 3+ years of clinical... ...record in coaching, performance management, and cross-functional...Remote job
- Comagine Health is seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess medical necessity and quality of care through... ..., concurrent, and retrospective utilization management reviews. This full-time, remote position supports compliant, cost-effective...Remote jobFull time
- ...relationships with respected organizations across all 50 states, we offer opportunities at leading health systems, hospitals, specialty clinics, and post-acute facilities. Thanks to our direct client partnerships and national MSP programs, you'll have the flexibility to work...Remote work
- ...Home Health Services in Mesa, AZ, seeks an experienced RN leader to join as Clinical Manager. You will mentor field clinicians, drive quality outcomes... ...role offers a hybrid structure with field, office, and remote components for flexible leadership. #J-18808-Ljbffr Sunrise...Remote workWork at officeFlexible hours
- Interwell Health is seeking a Clinical Supervisor to lead a team of RN Care Managers within our Virtual Clinical Services organization. This role provides direct supervision, coaching, and clinical leadership for coordinated assessments, education, care planning, and interventions...Remote job
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