Remote RN Medical Claims Reviewer
Broadway Ventures LLC
A leading healthcare consulting firm is seeking a dedicated Registered Nurse (RN) to join the Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with clinical guidelines. The successful candidate will have an active RN license and two years of clinical experience. Strong analytical and communication skills are essential. This position offers a remote work environment with all necessary equipment provided. #J-18808-Ljbffr
- ...Southcarolinablues is seeking a RN Medical Reviewer III (Remote in SC) to perform medical reviews using clinical information and established guidelines. This role involves reviewing complex medical claims and educating teammates on healthcare processes. The ideal candidate...Remote workClaimsWork from home
$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 medical... ...with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote workClaimsHourly pay- ...Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business...Remote workClaimsFull timeFor contractorsWork at officeHome officeMonday to Friday
- ...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... ...possess an Associate's degree and an active RN license. Responsibilities include ensuring...Remote workClaims
- ...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 jobClaimsFor contractorsLive inWork at office
- ...University of Minnesota School of Nursing is seeking a Clinical Claim Review Nurse who will perform claim reviews to verify coding and... ...U.S. Candidates must hold an associate's degree and an active RN license, with a minimum of 2 years of clinical experience. The...Remote jobClaims
- Texas Health Institute is hiring a Clinical Claim Review Nurse to perform claim reviews, ensuring... ...an Associate's degree, an active RN license, and at least 2 years of clinical... ...experience. Bountiful benefits, including PTO, medical plans, and 401(k), are offered to support...Remote jobClaims
- Optum is seeking a Clinical Claim Review Nurse to perform claim reviews and ensure compliance in a telecommute role. You will verify coding... ...necessary resources. This role requires an Associate's degree, active RN license, and clinical experience. You’ll enjoy comprehensive...Remote jobClaimsFlexible hours
- Optum is looking for a Clinical Claim Review Nurse to perform claim... ...federal policies. This fully remote position allows you to contribute... ...benefits including paid time off, medical plans, and a 401(k) savings... ...'s degree, an active RN license, and at least 2 years...Remote jobClaims
- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is... ...vaccine- and countermeasure-related injury claims. These programs provide compensation... ...OR advanced degree (e.g., NP, PA, RN). At least 3 years of experience conducting...Remote workClaimsHourly payContract work
$19 per hour
...NOW HIRING: Medical Claims Reviewer Location: Harrisburg, PA (Hybrid – 2 Days Onsite / 3 Days Remote) Pay Rate: $19.00/hour Schedule: Monday – Friday, 8:00 AM – 4:00 PM Overview A-Line Staffing is seeking a detail-oriented Medical Claims Reviewer...Remote workClaimsWork at officeImmediate startMonday to Friday2 days per week- A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing reports, and consulting with medical experts. Candidates must hold an MD/DO or relevant...Remote jobClaimsContract work
$220k - $230k
...steps. Our partner is looking for a Medical Director/ Physician Reviewer based in the United States. This... ...management, medical necessity review, or claims review strongly preferred.... ...Comfortable working independently in a remote, HIPAA-compliant environment with strong...Remote jobClaimsFull timeFlexible hours- ...professional in Miami to perform utilization reviews and ensure proper coding for... ...regulations. The candidate will evaluate medical claims and facilitate appeals, contributing to... ...assurance and regulatory compliance. An active RN license is essential, along with analytical...Remote workClaims
- Itemized Bill and Medical Record Reviewer job at Alaffia Health. New York, NY. About... ...have experience reviewing claim forms and auditing provider... ...Clinical license required (RN) preferred Experience working... ...access to Leadership LI-REMOTE #J-18808-Ljbffr Alaffia HealthRemote workClaimsFlexible hours
$29.05 - $67.97 per hour
...Molina Healthcare is seeking a qualified Registered Nurse with clinical experience to perform utilization reviews and ensure medical necessity of claims. The role involves reviewing medical documentation, facilitating appeals for authorizations, and validating claims...Remote workClaimsHourly pay$29.05 - $67.97 per hour
...Healthcare is seeking a Clinical Reviewer in Columbia, South Carolina. This... ...advanced clinical knowledge to assess medical necessity and ensure appropriate coding for claims. Candidates should have at least... ...applicant will hold an active RN license and must possess strong...Remote workClaimsHourly pay$29.05 - $67.97 per hour
...Molina Healthcare is seeking a Clinical Review Nurse to review medical documentation ensuring medical... ...for authorizations, validating medical claims, and working with various stakeholders... ...including utilization review, an active RN license, and strong analytical skills....Remote workClaimsHourly pay- A 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 workClaimsFull time
$29.05 - $67.97 per hour
...looking for a Clinical Nurse with experience in utilization review. The role includes reviewing medical claims and ensuring compliance with guidelines to support accurate reimbursement. Candidates must have an active RN license and at least 2 years of clinical experience....Remote workClaimsHourly pay- ...management, discharge planning and utilization review. Review admissions and service... ...prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement... ..., precertification, reimbursement and claim denials/appeals. Assess and coordinate...Remote workClaims
- ...intelligence company is seeking a Nurse Itemized Bill Reviewer to analyze medical claims and ensure compliance with industry standards. This remote position allows candidates to work from... ...candidates should possess an active RN, LPN, or LVN license, along with at least 1...Remote workClaims
- A leading medical service provider in Washington, DC is seeking a DME Medical Reviewer to ensure compliance with nursing standards and provide... ...candidate must hold an active RN license and have at least two... ...audits. The role emphasizes remote work capabilities and...Remote work
- ...join our dedicated team in a remote capacity. The Appeals Processor... ...(APP III) is responsible for reviewing, analyzing, and processing... ...years in: Healthcare appeals Medical claims / utilization review Insurance... ...(clinical roles may require RN) Responsibilities Duties Review...Remote workClaimsContract work
- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in... ...involves reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...enjoying the flexibility of a primarily remote work environment. If you are passionate...Remote workClaims
- ...Description Description: The Medical Nurse Reviewer applies clinical nursing expertise to review claims, medical records, and provider... ...Registered Nurse (RN) license in state of residence... ...Location and Environment 100% Remote PHI/PII Requirement: Yes. The...Remote workClaimsFull timeWork at officeFlexible hours
$50 - $53 per hour
...Job Title: Clinical Review RN (IDR/Appeals) Experience: Open... ...*** Location: Remote (can sit anywhere in the US as... ...benefits review, supporting Medical Review Analysts, and Physician... ...project expands. 4. Claims assessment and adjudication....Remote workClaimsLocal areaImmediate startFlexible hours- 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
$80k
...4-day work week, 4.5-day work week, telecommuting work option, remote work option. Employee referral bonuses. Free parking. Commitment... ...provide a higher quality of service. Transparency: While we don't claim to be 100% transparent (there are certain things, like salaries...Remote workClaimsFull timeFlexible hoursNight shiftAfternoon shift$35 per hour
...Description Telephonic Nurse Case Manager (1099 Remote - NJ RN License Required) We are currently... ...plans with providers, employers, and claims adjusters Monitor patient progress and facilitate appropriate medical care Maintain timely and accurate documentation...Remote workClaimsContract workLocal areaFlexible hours
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