Remote Medical Review Nurse | Government Claims Auditor
Machinify, Inc.
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 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
- ...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
$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$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- ...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
$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- ...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
- WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to prepare timely redeterminations...Remote jobMedicalClaims
- ...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
- ...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
- ...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
- ...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
$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$40 - $55 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$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- ...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
- ...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
- ...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
$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- ...Elevance Health is seeking a Clinical Review Nurse I - Medicare Part B to review claims for medical necessity under Part B policies. The role is remote with required in-person training and follows a 8 am–5 pm EST Monday–Friday schedule. It’s part of Wellpoint Federal,...Remote workMedicalClaimsMonday to Friday
- ...healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an... ...participating in ongoing training. This is a part-time remote position, offering a flexible work...Remote workMedicalClaimsHourly payPart timeFlexible hours
$41 per hour
...Remote position, however, candidates must reside in the State... ...managed 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 workMedicalClaimsContract work$78k - $88k
...It takes great medical minds to create powerful solutions that solve... ...Summary We are seeking a Nurse Reviewer (RN) who will be responsible... ...Cross-trains on multiple claim types to support business needs... ...through Friday work schedule.Remote role available to employees residing...Remote workMedicalClaimsFull timeMonday to FridayFlexible hours$70.8k - $123.8k
...Clinical Nurse Auditor CGI is one of the world's... ...with 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...Remote workMedicalClaimsWork at office- Location: New York, United StatesCompany: HumanaPosted: 2026-09-10Humana Inc. is seeking a Medical Coding Auditor for its Outpatient Facility/APC Coding Team. This remote role reviews claims, ensures CPT/HCPCS compliance, and interprets medical records to support accurate...Remote workMedicalClaims
- 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
- ...Inc. is seeking an experienced Certified Inpatient Medical Coding Auditor to review inpatient hospital claims, assign ICD-10-CM, ICD-10-PCS and DRG codes, and ensure... ...payment accuracy while supporting cost reduction. Remote work with occasional travel to Humana offices;...Remote workMedicalClaims
- Optum is seeking a Clinical Review Clinician to serve as a subject matter expert in itemized... .... The role involves clinical claim review, medical record evaluation, and research to support... ...strong documentation and adherence to HIPAA standards. #J-18808-Ljbffr Registered NurseRemote jobMedicalClaims
$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 workMedicalClaims
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medical Review Nurse | Government Claims Auditor. Be the first to apply!
- junior auditor United States
- compliance auditor United States
- premium auditor United States
- revenue auditor United States
- iso auditor United States
- medical claims auditor United States
- remote nurse auditor United States
- lease auditor United States
- medical records auditor United States
- energy auditor United States



