Remote RN: Clinical Claims Review & Documentation
Texas Health Institute
- Remote job
UnitedHealth Group seeks a SSBV Clinical Claims Review RN to administratively review short‑stay inpatient hospital claims, document decisions, and maintain screening criteria for claims processing in a dynamic production environment. The role requires an Associate’s degree, an RN license, and 5+ years in clinical documentation. Excellent MS Office skills and strong writing ability are essential for precise documentation and compliance. #J-18808-Ljbffr Texas Health Institute
- UnitedHealth Group is seeking a Clinical Claims Review RN to administer and document short‑stay inpatient hospital claim reviews. You will maintain screening... ...determinations in a dynamic production environment. This remote role requires an RN license, 5+ years of clinical...Remote jobClaimsWork at office
- Optum is seeking a Clinical Review Clinician to serve as a subject matter expert in itemized bill reviews and clinical claim analysis. The role involves documenting, researching, and identifying adjustments for payment while collaborating with a team within a framework...Remote jobClaims
- University of Minnesota School of Nursing seeks a SSBV Clinical Claims Review RN to perform administrative reviews of short-stay inpatient hospital claims, document determinations, and maintain screening criteria in a dynamic environment. Responsibilities include ensuring...Remote jobClaimsHome office
- UnitedHealth Group is seeking a licensed RN for a Telecommute Clinical Claims Review role. You will conduct administrative reviews of inpatient claims, document determinations, and apply screening criteria from Federal, State, and client requirements. The position requires...Remote jobClaimsWork at office
- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for... ...analysis of hospital facility bills. You will document, research, and identify adjustments as... ...framework and must understand the claim review process, clinical review,...Remote jobClaims
- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative documentation to identify fraud or wasteful practices. The role involves... ...is full-time (40 hours/week) with remote work options in Massachusetts and potential...Remote jobClaimsFull timeLocal area
$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays... ...precise clinical review and documentation, you will help support... ...applications This is a 100% remote role, and requires robust... ...data with post-service claims validation, we're...Remote workClaimsFull timeFlexible hoursShift work- ...seeking a highly motivated RN Clinical Appeals & Utilization Review for an opportunity in... ...Utilization Review Location: Remote – Ohio; Columbus area... ..., strong clinical documentation skills, and the ability to... ...documentation. Utilize multiple claims and appeals systems to...Remote jobClaimsTemporary workWork at officeMonday to FridayShift work
$29 - $52 per hour
...Clinical Review Clinician Optum is a global organization that delivers... ...reviewer is responsible for documenting, researching and identifying... ...comprehensive understanding of the claim review process including... ...~ Active and unrestricted RN license OR LPN in the state of...Remote workClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$29 - $52 per hour
...Program Integrity Clinical Compliance Auditor... ...performing compliance reviews of medical and administrative documentation to identify... ...providers who submit claims for payment. This position... ...This position is Remote in Massachusetts. You... ...~ Nurse licensure (RN or LPN) with a...Remote workClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work$80k - $90k
...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...medical review clinical and documentation audit team members, as... ...conducts research, analyzes claims data, applies knowledge... ...to work independently in remote setting with minimum supervision...Remote workClaimsFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$28.94 - $51.83 per hour
...Ssbv Clinical Claims Review Rn Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...and client specific requirements Responsible for documentation of all determinations Maintain accurate use of...Remote jobClaimsHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaHome office- ...Optum Waste And Error Claims Investigator Optum is a global organization... ...of the claim for further review in a production environment.... ...Primary Responsibilities: Clinical Case Reviews - 75% Perform... ...Examine, assess, and document business operations and procedures...Remote jobClaimsContract workWork at officeLocal areaMonday to Friday
- 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
$29 - $52 per hour
UnitedHealth Group is seeking a qualified Registered Nurse in Massachusetts to perform clinical coverage review services. As part of this role, you will communicate benefit determinations and work closely with healthcare providers to explain coverage. We offer telecommuting...Remote jobClaimsHourly pay$50 - $52 per hour
Claims Clinical Documentation Reviewer Schedule: 5-10 hours per week. Resource can work any day of the week they are available and any time including weekends if they prefer. Remote position. Equipment is provided by facility. Base pay: $50.00/hr - $52.00/hr. Reports...Remote workClaimsPart timeWork at officeLong distance10 hours per week$69.3k - $78k
...company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and... ...position requires an active RN license and a minimum of... ...include auditing claims and documenting findings, all in a remote work environment. This role...Remote jobClaims- ...Job Title: Clinical Review Nurse - Concurrent Review Location: Remote -Anywhere in US Shift : Tuesday... ...comprehensive review of clinical documentation, clinical criteria/... ...to resolve denial claims Assists with issues... ...Required: LPN or RN, active in any state...Remote workClaimsLocal areaShift work
$29 - $52 per hour
...challenges. Primary Responsibilities Perform clinical coverage review services, which require interpretation... ...'s degree Current unrestricted RN license in the state of Massachusetts... ...inpatient/acute setting 1+ years of clinical documentation experience A designated homework space...Remote workClaimsHourly payMinimum wageFull timeWork experience placementLocal area$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant,... ...primarily performs medical claims audit reviews. As a... .... You will work remotely in a fast paced and dynamic... ...policies and rules. Document all findings... ...Active unrestricted RN license in good standing...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work- ...UnitedHealth Group, seeks a Clinical DRG RN auditor to review MS-DRG and APR-DRG coding for inpatient claims and identify overpayments. The... ...ICD-10-CM/PCS accuracy, documenting rationales, and maintaining... ...audit outputs. You will work remotely from anywhere in the U.S. and...Remote jobClaimsRelocation package
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline... ...eligibility regarding benefits and clinical criteria and assess and... ...clinical proficiency and claims knowledge. This is a... .... Ensure accurate documentation of clinical information to...Remote workClaimsFull timeContract workLocal areaShift work
$41 - $43 per hour
...looking for a Medical Claims Review Nurse to work with... ...Client! Location: Remote (Candidates must reside... ...candidates must have a valid RN License and have... ...claims. Performs clinical/medical reviews of... ...clinical experience Documents clinical review summaries...Remote workClaimsHourly payWork at officeLocal area$50 - $52 per hour
A healthcare consultancy is seeking a Claims Clinical Documentation Reviewer for a part-time, remote role. The ideal candidate will possess a background in behavioral health services and a strong skill set in clinical documentation review. Responsibilities include reviewing...Remote workClaimsHourly payPart timeFlexible hours- ...Description The utilization review and management (UM)... ...facilities are medically necessary, clinically appropriate, evidence-based... ...with the logging and documentation of claims along the process chain.... ...This is an in-office, no remote work capability position...Remote workClaimsWork at office
$63k - $65k
...Services & Insurance RN Utilization Review As a nurse at... ...in a nontraditional clinical setting. Apply your... ...being of others in a remote work environment.... ...effectively with physicians, claims examiners, clients,... ...statements contained in this document are intended to...Remote workClaimsWork experience placementLocal areaFlexible hours- UnitedHealth Group is seeking a Clinical Claim Review RN in Massachusetts for full-time remote work. The role involves performing compliance reviews of medical and administrative documentation to identify fraud, waste, or abuse, using claims data, audits, and investigations...Remote jobClaimsFull timeLocal areaShift work
- ...Provide timely review and determination of medical claims, including prior authorization... ...regulatory back-up documentation contained within... ...Registered Nurse (RN),as required by... ...contract(s). ~1+ years clinical experience required... ...position Remote but need to be...Remote workClaimsContract workFor contractorsWork experience placementWork at officeLocal area
- ...dedicated Registered Nurse (RN) Clinical Denials and Appeals to... ...This role will be Full-Time Remote, Monday-Friday (8-Hours per... ...Job Responsibilities: Reviews denied claims to identify the appropriateness... ...accurate and complete documentation to support appeals....Remote workClaimsFull timeMonday to FridayFlexible hours
- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These... ...determinations as to the validity of health claims and levels of payment in meeting... ...Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS...Remote workClaimsPermanent employmentWork at officeLocal area
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