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
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain subject... ...conducts research, analyzes claims data, applies knowledge of... ...with company policies, government regulations and law.*... ...ability to work independently in remote setting with minimum supervision...Remote workMedicalClaimsFlexible hours$84k - $100k
A leading healthcare intelligence company is seeking a Medical Review Nurse II to perform audits on medical claims for government and commercial payers. This remote position requires a minimum of five years of nursing experience and an active RN license. Responsibilities...Remote workMedicalClaims- ...Function as a designated clinical resource to review High Cost Claimants to identify... ...assistance with information related to members' claims and clinical course, expected outcomes... ...coordinate with other departments such as medical and pharmacy account team to address ongoing...Remote jobMedicalClaimsFull time
$68k - $70k
Description Our Medical Review Nurse Analyst is responsible for conducting... ...Review Nurse Analyst reviews claims and delivers provider... ...experience. We are open to remote work in the following approved... ...health insurer and federal government contractor headquartered in...Remote workMedicalClaimsContract workFor contractorsLocal areaImmediate start- ...Medical Review Nurse - CMS RAC In October 2025, Machinify acquired... ...Nurse - CMS RAC (Government audits) primarily performs medical claims audit reviews for government... ...experienced medical auditors and coders performing... ...Payers. You will work remotely in a fast paced and...Remote workMedicalClaimsFor contractorsWork at officeShift work
- Machinify is seeking a Medical Review Nurse II to perform medical claims audit reviews for Government and Commercial Payers. This role requires an active RN license and at... ...years of relevant experience. The position is remote, and you will be part of a dynamic, multi-location...Remote jobMedicalClaims
$85k - $90k
...health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments and/or medical necessity for...Remote workMedicalClaimsWork at office- ...Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with... ...Small Business (SDVOSB), we empower government and private sector clients by delivering... ...are seeking a dedicated Registered Nurse (RN) to join our Medical Review team...Remote workMedicalClaimsFull timeFor contractorsWork at officeHome officeMonday to Friday
$59.3k - $80.9k
...part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records... ...ICD-10 and CPT coding principles, government regulation, protocols Use your skills... ...Information WORK STYLE: Remote/Work at home; minimal travel may be...Remote workMedicalClaimsFull timeTemporary workApprenticeshipWork from home- ...Senior Auditor Employment Type: Full Time, Mid-level CGS... ...district legal staff by conducting medical claims data analysis, forensic... ...people together to solve the government's most dynamic problems with... ...and investigators. Review defense presentations, expert...Remote workMedicalClaimsFull timeFlexible hours
$85k - $90k
...Cost Outlier and Readmission reviews. Under the direction of the... ...conduct reviews of inpatient claims for both coding accuracy as well... ...) College level courses in medical terminology, anatomy, pathophysiology... ...different tasks easily. Remote Work Requirements:...Remote workMedicalClaims$59.3k - $80.9k
...part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records... ...ICD-10 and CPT coding guidelines, government regulation and protocols... ...to make an impact WORK STYLE: Remote, work at home. While this is a remote...Remote workMedicalClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...-5pm Work Location: Remote Benefits for eligible... ...and utilization review. Review admissions and... ...concurrent and retrospective medical necessity and/or... ...precertification, reimbursement and claim denials/appeals.... ...Need ~ Registered Nurse credentialed from the Alabama...Remote workMedicalClaims
- ...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
$78.5k - $90k
...Performant Recovery, Inc. is hiring a Medical Review Nurse for remote work focusing on auditing medical claims for Home Health services. This role involves document audits, collaboration with audit teams, and staying updated on regulatory issues. The ideal candidate will...Remote workMedicalClaims- ...commercial insurance - we want to meet you. Medical Review Nurse Carbon Stop Loss Solutions is a... ...best-in-class service, underwriting, claims support and effective cost containment... ...Ability to work independently in a remote setting. Ability to work with multiple...Remote workMedicalClaims
$93.5k - $126.5k
...Nurse Analyst / Investigator We are GDIT... ...providers to the government, we own our opportunities... .... Writing and reviewing edit proposals and... ...regarding policy, medical coding, and... ...policy, processes and claims payment systems... ...Telecommuting Options: Remote Work Location: Any...Remote workMedicalClaimsContract workFor contractors$70.3k - $85.47k
...The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on... ...of medical care. This is a remote position in CA. ESSENTIAL FUNCTIONS... ...specific issues of concern to the claims examiner/client and/or direct...Remote workMedicalClaimsMinimum wageFull timeWork at officeLocal areaFlexible hours- Machinify is hiring a Medical Review Nurse II to perform audit reviews of medical claims for skilled nursing facilities. In this remote role, you'll work as part of a dynamic team to ensure compliance and appropriate service delivery. Responsibilities include reviewing...Remote jobMedicalClaims
$64k - $80k
It takes great medical minds to create powerful solutions that... ...As a Fraud and Abuse Review Nurse- Remote at Gainwell, you can contribute... ...Services, Member Services, Claims) to collect relevant documentation... .... Experience with government healthcare programs (Medicare...Remote workMedicalClaimsFull timeLocal areaWork from homeFlexible hours$35 per hour
...more. Base pay range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift Position Description... ...adjudication of Federal Emergency Services (FES) 1500 claim forms. Some coordination will be required with medical...Remote workMedicalClaimsHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shift- ...Nurse Auditor Lewiston, ID Exp 5-7 years This position can be... ...conduct and report on post payment claims audits and performs related... ...: Proven knowledge of medical and surgical procedures and... ...Demonstrated competency in claim review and experience in using...Remote workMedicalClaimsWork at office
$86k - $105k
...It takes great medical minds to create powerful solutions... ...direction of the Lead Nurse Consultant and Deputy... ...pre-payment compliance reviews to detect, combat, and... ...and financial records, claims, and claims data to obtain... ...Role is 100% remote Employees may be required...Remote workMedicalClaimsFull timeWork at officeFlexible hours- ...Medlogix, LLC delivers innovative medical claims solutions through a seamless... ...administrators (TPAs); and government entities we serve.... ...Provides comprehensive Medical Review Services, Medical Case Management... ...per week) Non-Exempt Remote- EST time zone POSITION...Remote workMedicalClaimsFull timeWork at office
- ...is looking for a detail-oriented Registered Nurse Clinical Auditor to support medical record reviews and billing compliance audits for the... ...certification, and at least 1 year of Medicaid claims review experience. This remote position requires occasional travel within...Remote jobMedicalClaims
- ...Stryker Corporation is seeking a Clinical Claim Review Nurse to perform detailed reviews of claims against medical records. The position offers the flexibility to telecommute within the U.S. and demands strong clinical skills along with a comprehensive understanding of...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
$70k - $80k
...company is seeking a Clinical Validation Auditor to ensure accuracy in medical claims coding. This fully remote position requires a Registered Nurse with over 5 years of acute care experience. Responsibilities include reviewing medical records, documenting findings, and...Remote jobMedicalClaims- ...occasional meeting, otherwise would be fully remote Must have an active LPN License. M... ...Pay 23/hr Description - Performs medical reviews using established criteria sets and/or... ...Provides support and review of medical claims and utilization practices. May...Remote jobMedicalClaimsFor contractorsLive inWork at office
- ...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... ...Job Type Contract Work Location Remote...Remote workMedicalClaimsContract workWork experience placementWork at office
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