Remote RN Claims Auditor - Healthcare Compliance
University of Minnesota School of Nursing
Boston, MA
- Remote job
UnitedHealth Group in Massachusetts is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative documentation, identifying fraud, waste, and abuse. The role involves site visits, data analysis, and presenting audit findings to clients using our auditing tools. The position is full-time, remote within Massachusetts, with standard 8-hour shifts and occasional overtime. The ideal candidate will have an active nursing license (RN/LPN), 2+ years of review #J-18808-Ljbffr University of Minnesota School of Nursing
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote RN Claims Auditor - Healthcare Compliance in Boston, MA vacancy
- Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy...Remote jobClaimsWork from home
- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative... ..., and collaboration with a team of auditors to document findings and input data... ...position is full-time (40 hours/week) with remote work options in Massachusetts and...Remote jobClaimsFull timeLocal area
- ...Medical Loss Ratio (MLR) examinations remotely, the full-time Senior Compliance Auditor will analyze documentation,... ...state and federal regulations in the healthcare and insurance sectors. Key... ...Perform testing of premium and claims transactions for accuracy and completeness...Remote workClaimsFull time
Virtual Vocations Inc
United States4 days ago - Healthcare Fraud Shield is seeking a Coding Auditor to perform routine coding reviews and ensure medical records align with billed codes. The role requires... ...by SIU management. The ideal candidate will review claims, abstract codes, and prepare written summaries while...Remote jobClaims
- ...Overview Compliance Auditor Full Time, 80 Per Hour Pay Period... ...This position is Remote. Covenant Health Overview... ...'s top-performing healthcare network with 10... ...or under payments of claim errors identified during... ...certification), or current TN RN License with...Remote workClaimsHourly payFull timeDay shift
Covenant Health (Tennessee)
United States10 hours ago - ...AuditorApplyremote type: Remote USlocations: Remote -... ...we’re reimagining the healthcare experience. Founded in... ...**Medical Coding Auditor** to join our positive... ...delivering top-tier coding compliance and accuracy for our... ...corrections of these claims when applicable, and performs...Remote workClaimsWork at officeLocal areaFlexible hours
ModMed
Brooklyn, NY3 days ago $71.1k - $97.8k
...Inpatient Medical Coding Auditor extracts clinical... ...review inpatient hospital claims for proper... ...Description WORK STYLE: Remote/work at home. While this... ...personal wellness and smart healthcare decisions for you and... ...affirmative action, in compliance with Section 503 of the...Remote workClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayHumana
Hartford, CT4 days ago$52.69 - $69.82 per hour
...time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration... ...and Coding Compliance Auditors conduct audits and monitoring... ...They review and evaluate healthcare regulatory compliance,... ...billing errors before claims submission, ensuring compliance...Remote jobClaimsHourly payFull timeWork experience placementWork at office$35 - $62.5 per hour
...position as a Clinical DRG RN auditor , you will apply your... ...auditing of inpatient claims. Employing both... ...Demonstrate knowledge of and compliance with changes and... ...and perform data entry Healthcare claims experience Managed... ...independently in a remote environment and deliver...Remote workClaimsHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package- ...Improvement / Quality Assurance / Compliance Registered Nurse (QI/QA/Compliance RN) The Quality Improvement /... ...Program Requirements, Federal Tort Claims Act (FTCA) standards, Uniform... ...in Alaska's rural, frontier, and remote healthcare environments. Essential Duties...Remote workClaimsWork at office
Bethel Family Clinic
Bethel, AK3 days ago - ...program integrity through compliance management. Here, you'... ...of care, and influence healthcare outcomes on ameaningful... ...to review and audit claims, supportprogram integrity... ...Registered Nurse (RN) license Strong clinical... ...vulnerable populations Remote work - enjoy the...Remote workClaimsFull timeTemporary workWork at office
The CKHobbie Group
Harrisburg, PA2 days ago - ...Review Nurse - Home Health Auditor Machinify is a leading healthcare intelligence company with... ...performs medical claims audit reviews with a focus... ...Commercial Payers. You will work remotely in a fast-paced and... ...nursing (active/unrestricted RN license) is required....Remote workClaimsWork at office
Machinify, Inc.
United States2 days ago - ...program ensures that external healthcare services provided across... ...while supporting regulatory compliance and organizational risk management... ...logging and documentation of claims along the process chain. #... ...This is an in-office, no remote work capability position Travel...Remote workClaimsWork at office
MedTrust LLC
Oklahoma City, OK6 days ago $29 - $52 per hour
...Program Integrity Clinical Compliance Auditor Optum Insight is... ...identify instances of healthcare fraud and/or wasteful... ...providers who submit claims for payment. This position... .... This position is Remote in Massachusetts. You... ...~ Nurse licensure (RN or LPN) with a current...Remote workClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift workdivvyDOSE
United States4 days ago- ...program integrity through compliance management. Here, you'... ...of care, and influence healthcare outcomes on a... ...setting to review and audit claims, support program integrity... ...unrestricted Registered Nurse (RN) license Strong... ...populations Remote work enjoy the convenience...Remote jobClaimsFull timeTemporary workWork at officeWork from home
- ...documentation in the Medical Record.Seeking RN candidates with a HCS-D - Home Care... ...Certificate for OASIS Specialist-Clinical. Remote position in New York.Job Responsibility1.... ...that proper standards are maintained in compliance with Federal and State regulations.5. Applies...Remote workHourly payFull time
FlexStaff Careers
Garden City, NY3 days ago - ...Examiner Nurse to audit provider and facility claims and contribute to quality improvement initiatives. The role requires an Oklahoma RN or LPN license, an associates degree, and... ...operations, with knowledge of coding and healthcare regulations. This is a full-time position...ClaimsFull time
$78.91k - $98.64k
...better future for healthcare. That starts by offering... ...inpatient claims and related inputs... ...facilities are in compliance with industry billing... ...and/or auditor. # Certified Professional... ...preferred. # RN, LPN or associate’... ...required to support remote or hybrid work....Remote workClaimsHourly payFull timeWork at officeWork from homeAfternoon shift- UnitedHealth Group is seeking a SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims... ...the U.S. while maintaining rigorous screening criteria and compliance with state/federal requirements. Qualified candidates will hold...Remote jobClaims
- Trillium Health Resources is seeking a Compliance Nurse to join our NC-based team. This exempt... ...on clinical compliance reviews and claims evaluation to ensure regulatory adherence... ...cases end-to-end. Candidates must be an RN with NC licensure and a valid driver's license...Remote jobClaimsFull time
- ...operations across a complex healthcare environment, with a strong... ...care risk assessment, claims management, regulatory compliance, and proactive risk reduction... ...18 months of hire) and RN license** JOB SPECIFIC COMPETENCIES... ...Hard Work Location: Remote (within Texas only)...Remote workClaimsFull timeTemporary workWork experience placementLocal areaWorldwideRelocation packageShift work
MD Anderson
Remote14 days ago $70.8k - $123.8k
Clinical Nurse Auditor Position Description... ...and necessity of healthcare services provided... ...inpatient and outpatient claims, evaluate medical... ...This position is remote within the United... ...policies and compliance requirements Required... ...Registered Nurse (RN) license in your...Remote workClaimsWork at officeLocal areaAtlanta, GA28 days ago- ...Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory... .... The role requires RN licensure in NC, travel within... ...catchment, and the ability to work remotely within North Carolina. Expect...Remote jobClaims
- ...quality audits within the UM program. The focus is on CMS/NCQA compliance, data analysis, and risk trends, leveraging Power BI for dashboards... ...ability to translate findings into actionable improvements. Remote work and travel for training may be required. #J-18808-Ljbffr...Remote job
$65k - $90k
Dane Street is seeking a Clinical (RN) QA Specialist in Washington, D.C. to ensure accuracy and compliance in long-term disability claims. This role involves assessing physician reports and providing excellent customer service by managing complex cases. Ideal candidates...Remote jobClaims- A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor... ...'s degree in healthcare and valid RN license in Florida. Key...Remote jobClaims
$49.92k - $58.24k
...looking for a detail-oriented Claims Auditor to join our team in Sherman... ...processing within a dynamic healthcare management environment. If... ...accuracy, completeness, and compliance with payer guidelines and contractual... ...in the healthcare industry. This is a remote position....Remote workClaimsFull timeWork at office$30.5k - $42.5k
A leading healthcare solutions provider is looking for a Medical Claims Auditor to work remotely from Texas. The ideal candidate will review and analyze medical claims for accuracy and compliance, validate coding, and identify errors. With at least three years of relevant...Remote workClaimsGainwell Technologies
United States1 day ago- A leading healthcare company is seeking an Inpatient Medical Coding Auditor to join their team remotely. The role involves reviewing inpatient hospital claims for proper reimbursement, analyzing medical data, and ensuring accuracy in coding. Candidates should have relevant...Remote workClaims
Humana
United States1 day ago - A 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 workClaims
Med Review Inc
New York, NY5 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Claims Auditor - Healthcare Compliance. Be the first to apply!
Related searches