Remote Medical Review Nurse | Government Claims Auditor
Machinify
- Remote job
Machinify is looking for a Medical Review Nurse to perform medical claims audits for government clients. This remote position requires expertise in coding and a minimum of five years nursing experience. You will work alongside a dedicated team in a dynamic environment, focusing on improving healthcare outcomes. The ideal candidate will possess strong communication skills and must have an active RN license. Relevant experience in claims review and medical coding is essential for this role. #J-18808-Ljbffr Machinify
- ...Medical Review Nurse - Home Health Auditor Machinify is a leading healthcare intelligence company... ...primarily performs medical claims audit reviews with a focus... ...audits on claims for Government and Commercial Payers. You will work remotely in a fast-paced and dynamic...Remote workMedicalClaimsWork at office
- 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 jobMedicalClaimsWork from home
$69.3k - $78k
...healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and Commercial Payers. The position... ...claims and documenting findings, all in a remote work environment. This role offers a...Remote jobMedicalClaims- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've... ...containment. Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...Remote workMedicalImmediate start
$59.3k - $80.9k
...Medical Coding Auditor Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided,... ...CPT coding guidelines, government regulation and protocols... ...Work Style: Remote, work at home. While this...Remote workMedicalClaimsBi-weekly payContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...growing healthcare platform, the full-time Medical Review Nurse will ensure compliance with CMS... ...and maintain data security while working remotely. Key Responsibilities Review DMEPOS orders... ..., utilization management reviews, or claim audits Proficiency with medical review...Remote workMedicalClaimsFull timeFlexible hours
$78k - $88k
...It takes great medical minds to create powerful solutions that... ...individual for a Lead Coding Auditor, Itemized Bill Review and Appeals who is... ...perform reviews of multiple claim types to provide a flexible... ...expect in this role ~100% Remote Position ~ Up to 25% travel...Remote workMedicalClaimsFull timeContract workFlexible hours- ...Description Physician Peer Reviewer – Multiple Specialties... ...Independent Medical Review Organization (IRO... ...healthcare organizations, government agencies, insurance... ...with independent review claims and appeals in any of... ...external reviews Job Type Contract Work Location Remote...Remote workMedicalClaimsContract workWork experience placementWork at office
- ...Snapshot The Appeals Nurse examines medical records and claims information for first-level... ...are medically reviewed as needed and completed timely... ...Location We are open to remote work in the following approved... ...insurer and federal government contractor headquartered...Remote workMedicalClaimsContract workFor contractorsLocal areaImmediate start
- ...conduct and report on post payment claims audits and performs related... ...: •Proven knowledge of medical and surgical procedures and other... ...competency in claim review and experience in using billing... ...competencies listed above: •Nurse Auditor would have a/an Associate or...Remote workMedicalClaimsWork at office
- ...Claims Review Management Nurse (RN) We are seeking an experienced Claims Review Management Nurse (RN)... ..., with a hybrid schedule (three days remote, two days onsite). This position plays... ...along with familiarity with Medicare and Medical Assistance guidelines. Experience...Remote workMedicalClaimsLong term contractFull timeContract workWork at office2 days per week
$38 - $43 per hour
...Medical Reviewer, RN - Temporary Position Location: Remote *This role is a temporary position and that employment is expected... ...review, and analysis of medical claims, records, data, and audits... ...Active license as a Registered Nurse, in good standing, in the United...Remote workMedicalClaimsHourly payTemporary workFor contractorsLocal area$75k - $85k
Job Details Job Location: Remote - Remote Employees, VA 12345 About Capitol Bridge Founded... ...independent medical reviews, records/data management services, medical... ...seeking an experiencedClaims ReviewNurse. The Claims ReviewPositionwill play a crucial role in...Remote workMedicalClaims- ...leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and...Remote workMedicalClaimsFull time
- ...Utilization Management Care Reviewer, you will be an... ...Networks Team. This 100% remote role manages a typical... ...departments including Claims. The schedule for your... ...Department, will determine the medical appropriateness of... ...Bachelor's degree in nursing or equivalent working knowledge...Remote workMedicalClaimsFull timeMonday to FridayShift work
$35 per hour
...to learn more. Base pay range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift Position Description The role... ...adjudication of Federal Emergency Services (FES) 1500 claim forms. Some coordination will be required with...Remote workMedicalClaimsHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shift- ...A healthcare organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The role involves examining claims, maintaining... ...This position offers a chance to work in a remote setup with competitive hours. Benefits include...Remote workMedicalClaims
- ...Management Department (Fully Remote)Job Summary:• Provides health... ...discharge planning and utilization review.Responsibilities:• Reviews... ...concurrent and retrospective medical necessity and/or compliance with... ...precertification, reimbursement and claim denials/appeals.• Assesses and...Remote workMedicalClaims
- ...applicants This is full-time remote, but candidates must reside... ...care industry using medically accepted criteria to validate... ...accurate and timely medical review of claims suspended for medical necessity... ...skills. ~ Registered Nurse (RN) with unrestricted license...Remote workMedicalClaimsFull timeContract work
$78.91k - $98.64k
...of hospital inpatient claims and related inputs. Determines... ...Benefits : ~ Medical, Dental, Vision,... ...billing coordinator and/or auditor. # Certified Professional... ...# Prior experience in review of medical records.... ...connection required to support remote or hybrid work. Must be...Remote workMedicalClaimsHourly payFull timeWork at officeWork from homeAfternoon shift- ...Description The utilization review and management (UM)... ...facilities are medically necessary, clinically appropriate... ...and documentation of claims along the process chain... ...~ Registered nurse with active, unincumbered... ...This is an in-office, no remote work capability position...Remote workMedicalClaimsWork at office
- Commence is seeking a Nurse Reviewer to perform complex medical record reviews of Medicare Part A/B and DMEPOS claims. The role requires clinical judgment to assess payment validity... ...to CMS guidelines. The position is remote, offering flexibility while demanding high...Remote jobMedicalClaims
- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in Phoenix.... ...reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...the flexibility of a primarily remote work environment. If you are passionate...Remote jobMedicalClaims
- ...efficiency of the use of Medical Services for Long-Term... ...and concurrent review. Provides monthly telephonic... ...appropriateness of care and accurate claims payment. May also... ...Info: *possible remote opportunity after training... ...Requires an AS/BS in Nursing At least 2 years of acute...Remote workMedicalClaimsContract workMonday to FridayFlexible hours
$70.8k - $123.8k
Clinical Nurse Auditor Position Description CGI... ...commercial and government clients to deliver... ...clinical audits of medical records to determine... ...documentation skills to review inpatient and outpatient claims, evaluate medical... .... This position is remote within the United States...Remote workMedicalClaimsWork at officeLocal area$40 per hour
...PT (20-30 hours week) – Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical... ...reviews and policy reviews for Medicaid claims. This involves meticulous examination of...Remote workMedicalClaimsContract workWork at officeLocal areaImmediate start- ...straight to better care.? Requirements The Nurse Reviewer performs complex medical record reviews of Medicare Part A/B and DMEPOS claims that require clinical judgment in order to... ...the essential functions. This is a remote position. While performing the duties of this...Remote workMedicalClaimsContract workFor contractorsLocal area
- ...The Utilization Review Nurse gathers demographic and clinical information... ...treatment, certifies the medical necessity and assigns an appropriate... ...and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS... ...concern to the appropriate claims staff/customer Collects data...Remote workMedicalClaimsMinimum wageWork at officeLocal areaFlexible hours
$2,210 per week
...more exclusive features. Nurses – are you looking for a... ...benefits, including medical, dental, vision, long-term... ...Work-life balance. Remote/hybrid setting (once trained... ...to a second level reviewer. This individual interfaces... ...'s status, benefit and claim concerns, and...Remote workMedicalClaimsFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours- ARC Group is seeking a Clinical Review Nurse for a 100% remote position. The role focuses on reviewing health claims, determining medical necessity, and ensuring alignment with national and local policies and standards of care. Must hold a nursing degree and RN license,...Remote jobMedicalClaimsLocal area
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