Remote Clinical Claim Review RN Coding & QA Expert
Registered Nurse
Optum is seeking a Clinical Claim Review Nurse to perform claim reviews and ensure compliance in a telecommute role. You will verify coding accuracy and support health outcomes by connecting people with necessary resources. This role requires an Associate's degree, active RN license, and clinical experience. You’ll enjoy comprehensive benefits, including health plans, paid time off, and a flexible work environment. #J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical Claim Review RN Coding & QA Expert in Minneapolis, MN vacancy
- ...University of Minnesota School of Nursing is seeking a Clinical Claim Review Nurse who will perform claim reviews to verify coding and charges. You will work independently and... ...must hold an associate's degree and an active RN license, with a minimum of 2 years of clinical...Remote workClaims
University of Minnesota School of Nursing
Minneapolis, MN5 days ago - ...Texas Health Institute is hiring a Clinical Claim Review Nurse to perform claim reviews, ensuring correct coding and charges. Telecommute from anywhere within the U.S. while... ...possesses an Associate's degree, an active RN license, and at least 2 years of clinical experience...Remote workClaims
Texas Health Institute
Minneapolis, MN4 days ago - ...Stryker Corporation is seeking a Clinical Claim Review Nurse to perform detailed reviews of claims against medical records. The position offers... ...Candidates should possess an Associate's degree and an active RN license. Responsibilities include ensuring compliance with guidelines...Remote workClaims
Stryker
Minneapolis, MN5 days ago - ...Optum is looking for a Clinical Claim Review Nurse to perform claim reviews and ensure compliance with... ...state and federal policies. This fully remote position allows you to contribute to... ...possess an Associate's degree, an active RN license, and at least 2 years of...Remote workClaims
Crains Cleveland
Minneapolis, MN4 days ago - UnitedHealth Group is seeking a Clinical Review Clinician in Plymouth, Minnesota. This role involves... ...forensic reviews of hospital bills and claims while ensuring compliance with billing... ...have an Associate's degree, an active RN or LPN license, and at least 2 years of...Remote jobClaims
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records... ..., analyzes claims data, applies... ...Become subject matter expert for assigned... ...ICD-9/ICD-10/MS-DRG coding may be necessary.*... ...independently in remote setting with minimum... ...Active unrestricted RN license #J-18808-...Remote workClaimsFlexible hoursPerformant
Florida, NY4 days ago- Optum is hiring a Clinical DRG RN auditor to verify DRG coding accuracy and reimbursements while telecommuting from anywhere in the U.S. In this role, you... ...use your ICD-10 coding expertise to audit inpatient claims, identify overpayments, and support your findings with...Remote jobClaims
$28.94 - $51.83 per hour
...Clinical Review Clinician Optum is a global organization that... ...as a subject matter expert for itemized bill reviews... ...understanding of the claim review process including... ...Active and unrestricted RN license OR LPN in the... ...Qualifications: Auditing and coding certifications...Remote jobClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$65k - $75k
Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical... ...experience, and 2+ years in utilization review or claims auditing. This full-time position offers health benefits...Remote workClaimsFull timeGainwell Technologies LLC
Orange Beach, AL4 days ago- ...for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing... ...documenting decisions based on established clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical...Remote workClaimsFull time
BlueCross BlueShield of South Carolina
Columbia, SC1 day ago - ...company located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring compliance... ...guidelines. This role requires an active RN license and the ability to analyze claims data and regulations effectively. The...Remote workClaims
Performant
Florida, NY5 days ago - ...hybrid, onsite or remote. While the majority... ...Customer Service, Claims Processors, and... ...activities. Provide clinical and operational analysis... ...Conduct clinical review of complaints... ...and subject matter experts. Practice... ...of CPT-4 and ICD coding Knowledge of URAC...Remote workClaimsFull timeWork experience placementWork at office1 day per week
Blue Cross Blue Shield of Arizona
Phoenix, AZ5 days ago $70k - $80k
...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... ...care experience. Responsibilities include reviewing medical records, documenting findings, and...Remote jobClaims$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Review Clinician to perform Forensic Reviews on hospital bills, assisting with claims resolution and departmental goals. The role requires strong clinical knowledge and the ability to analyze charge details comprehensively. Benefits...ClaimsHourly pay- ...Barbara Cottage Hospital is seeking a clinical professional for a fully remote role focused on medical management.... ...requires an active New York State RN licensure and involves analyzing authorization... ...providers, conduct clinical reviews, and ensure that members receive the...Remote workFlexible hours
Santa Barbara Cottage Hospital
New York, NY2 days ago $69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant... ...performs medical claims audit reviews. As... .... You will work remotely in a fast paced... ...; assist with QA functions and... ..., CPT-4 or HCPCS coding. Knowledge of insurance... ...unrestricted RN license in good standing...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work- Stryker Corporation is looking for a Clinical Claims Review RN to perform reviews of inpatient hospital claims. This role supports a high-volume environment and allows for telecommuting from anywhere in the U.S. The ideal candidate must have an RN license, a minimum of...Remote jobClaims
$36 - $48 per hour
...Santa Barbara Cottage Hospital is seeking a Medical Claims Clinical Review Nurse for a remote position. This role involves conducting clinical reviews of... ...compliance with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote workClaimsHourly paySanta Barbara Cottage Hospital
New York, NY2 days ago- Optum, part of the UnitedHealth Group, is looking for a Clinical Claims Review RN to conduct administrative reviews of inpatient hospital claims. Ideal candidates will have a strong background in clinical documentation and RN qualifications. The role emphasizes telecommuting...Remote jobClaims
- Optum, part of the UnitedHealth Group, is looking for a Clinical Claims Review RN to conduct administrative reviews of short stay inpatient hospital claims. This position is open to telecommuting from anywhere in the U.S. and is situated in a high-volume, production-driven...Remote jobClaims
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Claims Review RN to perform administrative reviews of short-stay inpatient hospital claims. This role supports a production-driven environment and allows telecommuting from anywhere in the U.S. The ideal candidate must have an associate...Remote jobClaimsHourly pay$95k - $105k
...a Supervisor for Quality Assurance (Clinical) in Plantation, Florida. This role involves leading a remote team of nurses, overseeing clinical review audits, and ensuring quality standards... ...combined with expertise in healthcare claims auditing. The position offers a...Remote workClaimsPerformant
Plantation, FL4 days ago$29.05 - $67.97 per hour
...seeking a qualified Registered Nurse with clinical experience to perform utilization reviews and ensure medical necessity of claims. The role involves reviewing medical documentation... ...for authorizations, and validating claims coding. The ideal candidate must have at least two...Remote jobClaimsHourly pay$29.05 - $67.97 per hour
...Healthcare in Bellevue, WA is looking for a clinical reviewer with at least 2 years of nursing experience.... ...records and determining the medical necessity of claims. Candidates should have an active RN license, knowledge of coding, and strong analytical skills. The position...Remote jobClaimsHourly pay- ...in Cleveland, Ohio, is seeking a Clinical Nurse to handle medical documentation reviews and ensure compliance with medical... ...medical reviews, verifying claims accuracy, and resolving escalated... ...communication skills. Proficiency in coding is essential. Competitive benefits...Remote jobClaims
- ...for authorization and reimbursement. You will review claims, ensure compliance with regulations, and... ...hearings. The ideal candidate has 2+ years of clinical experience, with a strong background in utilization review and coding. We offer a competitive compensation package...Remote jobClaims
$29.05 - $67.97 per hour
Molina Healthcare is seeking a Clinical Nurse Reviewer in Albany, NY, responsible for reviewing medical documentation... ...medical reviews of appeals and validating claims for coding compliance. Candidates must hold an active RN license and have at least 2 years of clinical...Remote jobClaimsHourly pay$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals) Experience: Open to various clinical backgrounds... ...State RN license*** Location: Remote (can sit anywhere in the US as long as... ...RNs as the project expands. 4. Claims assessment and adjudication. 5....Remote workClaimsLocal areaImmediate startFlexible hoursMedix
Jericho, NY3 days ago- Stryker Corporation is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews. This role involves analyzing hospital bills, conducting forensic reviews, and maintaining compliance with HIPAA standards while working independently...Remote jobHourly pay
- MedPOINT Management is seeking a Medical Claims Clinical Review Nurse to ensure the accuracy and quality of medical claims from a remote location. The ideal candidate holds a valid RN license in California and has at least 3 years of nursing experience. Responsibilities...Remote jobClaims
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Claim Review RN Coding & QA Expert. Be the first to apply!
Related searches
- prn registered nurse Minneapolis, MN
- pediatric rn Minneapolis, MN
- home health rn Minneapolis, MN
- nurse rn Minneapolis, MN
- med surg medical surgical rn registered nurse Minneapolis, MN
- ob gyn rn Minneapolis, MN
- cath-lab rn Minneapolis, MN
- non clinical rn Minneapolis, MN
- registered nurse pharmacy Minneapolis, MN
- rn network Minneapolis, MN