Remote Medicare Appeals RN - Fast-Paced, Impactful Review
Medasource
- Remote job
Medasource is seeking an experienced Clinical Appeals Registered Nurse (RN) to support the Medicare appeals team for a leading healthcare insurance client. This fully remote opportunity focuses on reviewing clinical appeals, evaluating medical necessity, and ensuring timely determinations per Medicare guidelines. The ideal candidate has direct Medicare clinical appeals experience, strong utilization review knowledge, and can work independently in a fast-paced environment. #J-18808-Ljbffr Medasource
- 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... ...to detail is essential for success in this fast-paced environment. #J-18808-Ljbffr WPS Health SolutionsRemote job
$95k - $110k
...honed your career in a fast-moving medical environment... ...for a DRG Nurse Reviewer Appeals and Hearings to coordinate... ...required CEUs to maintain RN license and/or coding... ...to multi-task in a fast-paced production environment.... ...expect in this role Remote (Work from Home) Up to...Remote workFull timeWork from homeRelocation packageFlexible hours$95k - $110k
...honed your career in a fast-moving medical environment... ...for a DRG Nurse Reviewer Appeals and Hearings to coordinate... ...required CEUs to maintain RN license and/or coding... ...to multi-task in a fast-paced production environment.... ...expect in this role Remote (Work from Home) Up...Remote workFull timeWork from homeRelocation packageFlexible hours- ...solutions company, is hiring an Appeals Nurse to review medical records and claims... ...necessity and adherence to Medicare guidelines. The role... ...compliance with CMS requirements. Remote work is available from select... ...include an ASN/BSN, an active RN license, 1+ year of clinical...Remote job
$66k - $68k
WPS, a health solutions company, seeks an Appeals Nurse to review first-level appeal cases, assess medical necessity, and prepare rationale-supported... ...and communication skills are essential. The role offers remote work options across approved states, with a base salary in...Remote job- WPS, a health solutions company, is seeking an Appeals Nurse (RN) to review medical records and Medicare denial cases for medical necessity. The role collaborates... ...experience and strong communication skills. Remote work options available for approved states, including...Remote job
- WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and claims for first-level Medicare appeal cases, assessing medical necessity and adherence to CMS guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations...Remote job
- WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and CMS-denial redeterminations. You will collaborate with Appeals... ..., with strong communication and detail orientation. Remote-friendly with eligibility to work in designated states. #J...Remote job
- WPS is seeking an Appeals Nurse to review medical records and Medicare claim information for first-level appeal cases. You will collaborate... ...with CMS guidelines. Required RN license, ASN/BSN, and 1+ year clinical experience. Remote work is permitted in several states, including...Remote job
- ...solutions company is seeking an Appeals Nurse to review medical records and claims information for first-level Medicare appeal cases, determining... ...with CMS guidelines. The RN collaborates with Appeals Examiners... ...redeterminations. This remote role is eligible in several...Remote job
$52 - $56 per hour
...Contract RN For New York Health Plan You've done UM. You've worked appeals. Now find a role that uses both. We... ...New York health plan (Medicare Advantage, Medicaid and... ...management. 100% remote (U.S.) | Contract | $5... ...investigation, clinical review, decision and notification...Remote jobContract workAfternoon shift- ...candidates from first contact to hire in a fast-paced environment. This role emphasizes... ...relationship-building, with weekly pay and remote or hybrid work opportunities depending on... ...recruiting expertise and make a direct impact on hiring success. #J-18808-Ljbffr Product...Remote jobWeekly pay
$43 per hour
...Description Clinical Review Nurse (RN) | MDS, Quality & Incident... ...4:30 PM Location: Remote/Hybrid with occasional... ...as needed Make an Impact in Long-Term Care... ...Support hearings, appeals, and stakeholder inquiries... ...a highly documented, fast-paced, remote environment....Remote workWork at officeMonday to Friday- ...Nurse for the Emergency Department. Join a fast-paced team delivering expert care to patients... ...Requirements include one year of experience, WI RN license, and BLS & ACLS. Fort HealthCare... ..., supporting your growth and community impact. #J-18808-Ljbffr Fort Healthcare IncShift work
- ...Cardiac Cath Lab nurse to support the team in a fast-paced environment. This role involves acting as... ...with clinicians to prep patients, review history and physicals, and administer medications as directed. Wisconsin RN licensure, BLS, and ALS or PALS certification...ReliefWeekend workDay shift
- WPS Health Solutions seeks an Appeals Nurse (RN) to review medical records for first-level appeal cases... ...and determine medical necessity under Medicare guidelines. The role collaborates... ...clinical experience are required, with remote work options available in designated...Remote job
- HealthEdge is seeking a remote (US) Appeals & Grievances Specialist to independently process complex grievances and conduct medical necessity reviews across inpatient, outpatient, and ancillary services. You will prepare documentation for regulatory standards and coordinate...Remote job
- ...Health Solutions is seeking an Appeals Nurse to review medical records and claims... ...medical necessity under Medicare guidelines. The role collaborates... ...and completed. A valid RN license and 1+ year clinical... ...experience are required, with remote work options available in approved...Remote job
- WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records for first-level appeal... ...and determine medical necessity under Medicare guidelines. You will collaborate with... ...communication and regulatory knowledge. Remote work is available in approved states,...Remote job
- WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first... ...-level appeal determinations under Medicare guidelines. The RN collaborates with Appeals Examiners... ...with 1+ year clinical experience. Remote work is allowed in several states with...Remote job
- ...health solutions company is seeking an Appeals Nurse to review medical records and claims for first-level... ...medical necessity and adherence to Medicare coverage guidelines. The role collaborates... ...hold an ASN/BSN with an active RN license and 1+ year of clinical experience...Remote job
- WPS Health Solutions is seeking an Appeals Nurse to review medical records for first-level appeals... ...determine medical necessity under Medicare guidelines. The RN collaborates with Appeals Examiners... ...clinical experience are required. Remote work options are available in...Remote job
- ...is seeking qualified registered nurses for remote, home-based positions across the United States. Ideal candidates hold a Compact RN license and reside in a Compact US state.... ...nursing experience and a minimum of 1 year in fast-paced settings such as ED or ICU. A reliable...Remote jobFlexible hours
- Optum is seeking a Per Diem Utilization Management Nurse to review medical records and craft defensible appeal letters. You will extract pertinent case details, adhere to HIPAA, and follow OPAS/Optum guidelines while meeting time expectations. The role offers telecommuting...Remote jobDaily paidLocal area
- WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and claims for first-level... ..., determining medical necessity and Medicare coverage compliance. The RN... ...timely manner. This position supports remote work in approved states, including Ohio...Remote job
$53 per hour
Phaxis - Healthcare is hiring for a REMOTE RN opportunity focused on Grievance & Appeals and Utilization Review. The role requires candidates to reside in New York State and hold an active NY RN license. The schedule is Monday-Friday, 9 AM-5 PM, with compensation at $53...Remote jobLong term contractContract workMonday to Friday- WPS—A health solutions company is seeking an Appeals Nurse (RN) to review medical records and claims for first-level appeal cases to determine medical necessity under Medicare guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations. In...Remote job
- WPS is seeking an Appeals Nurse (RN) to review medical records and denial information for first-level Medicare appeals, ensuring services meet medical necessity and CMS guidelines... ...+ year of clinical experience, and offers remote work options in approved states, including...Remote job
- NTT DATA, Inc. is seeking a Clinical Reviewer Specialist for a fully remote position based in Florida. You will... ...necessity reviews for member and provider appeals, evaluating records and criteria to... ...NCQA compliance. The role requires RN licensure (Florida or compact), 3+...Remote job
- WPS Health Solutions is hiring an Appeals Nurse RN to review medical records and claims for first-level appeal cases to determine medical necessity according to Medicare guidelines. This remote-friendly role supports timely redeterminations and collaborates with Appeals...Remote job
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