Remote Payment Integrity Nurse I: Claims & Coding
Cambia Health
- Remote job
Cambia Health seeks a Payment Integrity Nurse I to join a mission-driven team, working from home within OR, WA, ID, UT, or ND. The role focuses on applying nursing expertise to ensure compliant medical and reimbursement policies, reviewing claims and medical records, and collaborating across departments to resolve issues. The position requires an unrestricted licensed RN or health/human services degree, with preferred CPC/AHIMA/AAPC certification and strong analytical, communication, and #J-18808-Ljbffr Cambia Health
- ...Ensuring the accuracy and compliance of claims and payments, the full-time remote Payment Integrity Specialist will manage payment audits, identify discrepancies... ...knowledge of healthcare claims lifecycle and coding systems (CPT, HCPCS, ICD-10, DRG) Exposure to value...Remote workClaimsFull timeContract work
- ...Job Title: Payment Integrity Auditor / Data Mining Auditor Location: Remote Schedule: Full-time (40 hours/week) | Monday–Friday... ...you will analyze paid medical claims data feeds received from... ...DOS, COBOL, AS400). Medical Coding Credentials: Active coding certification...Remote workClaimsDaily paidFull timeContract workMonday to Friday
$66.94k - $101.26k
...The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits based on client, policy, industry standards... ...guidelines. This is a remote position. ESSENTIAL... ...claims processing, ICD-10 Coding, DRG Validation, Coordination...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$112.7k - $193.2k
...product strategy for one of Optum Payment Integrity's Professional Claim Review products. These are established... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ...methodologies - including CPT/HCPCS and E/M coding; NCCI edits; physician fee...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaShift work- ...Payment Integrity Drg Coding & Clinical Validation Analyst The Payment Integrity... ...and audits acute inpatient claims. Integrates medical chart coding... ...(RHIA or RHIT) or a Nursing Degree. Three (3) years'... ...There may be opportunity for remote work within all jobs posted...Remote workClaimsWork experience placement
$72.8k - $130k
...Payment Integrity Clinical Review Specialist Optum is a global organization... ...the flexibility to work remotely from anywhere within the U.S... ...investigations Conduct provider claim and clinical audits,... ...VA policies, payment rules, coding guidelines, and clinical judgment...Remote jobClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$73.35k - $113.25k
...Description Job Description The Payment Integrity Analyst (Team Lead) assists... ...reviewing pre and post pay claim audits based on client,... ...healthcare policies. This is a remote position. ESSENTIAL... ...of claims processing, ICD-10 Coding, DRG Validation, Coordination...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$110.5k - $150k
...role: As our Senior Payment Integrity Program Development... ...behind Devoted’s clinical claim edit and audit... ...facility/professional coding frameworks (MS-DRG, APR... ...An active Registered Nurse (RN) license with direct... ...development. #LI-DS1 #LI-Remote Salary range: $110...Remote workClaimsFull timeContract workInternshipLocal area$200.4k - $343.5k
...Software Engineering for Optum Payment Integrity within the Optum Insight... ...enjoy the flexibility to work remotely * from anywhere within the U... ...seamless integration across claims editing, payment accuracy,... ...payment integrity, claims editing/coding, clinical validation, or...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal area$75k - $100k
Senior Analyst, Edits | Payment Integrity (Remote) Position Description CGI is seeking a results... ...subject matter expert, blending deep coding domain expertise with advanced analytics... ...Identify Opportunities: Use claim data analysis to pinpoint high-impact...Remote workClaimsLocal area$77.96k - $120.37k
...Job Description The Payment Integrity Supervisor is responsible... ...customers. This is a remote position. ESSENTIAL FUNCTIONS... ...Strong understanding of claims processing, ICD-10 Coding, DRG Validation (if... ...~ Associate Degree in Nursing or higher required as applicable...Remote workClaimsDaily paidMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$64.83k - $85.09k
...a Senior Analyst to join our Payment Integrity team. Oscar is the first health... ...resolution in the Oscar claim environment for both the Oscar... ...Work Location: This is a remote position, open to candidates... ...Research industry standard coding rules, summarize and provide...Remote workClaimsFull timeContract workWork at office$95k - $120k
...OR BSN **Current coding certification OR ability... ...to sit 100% remote. This person should... ...either facility-based nursing, clinical... ...-DRG, and APR-DRG payment systems. This position... ...quality recoverable claims for the benefit of... ...for this role: Integrates medical chart coding...Remote workClaimsHourly payFull timeLocal areaImmediate startMonday to Friday$76.5k - $103.5k
...Payment Integrity Nurse I Work from home within Oregon, Washington, Idaho, Utah, or North Dakota... ...better. As a member of the Post Service Claim Review team, our Payment Integrity... ...reimbursement of claims and accuracy of coding. Applies resources, including but not...ClaimsFull timeImmediate startWork from homeFlexible hours$22.78 - $29.62 per hour
Location Remote - Florida US:FL:Fort Myers Department Department of Revenue Integrity Work Type Full Time Shift Shift 1... ...reduce or prevent future claim denials. Employs... ...applicable billing, coding and reimbursement regulations... ...requirements and APC payment status and changes....Remote workClaimsFull timeShift work- ...Registered Nurse: Review and EvaluationAre you a registered nurse ready to take your career... ...role focused on advocacy and program integrity through compliance management. Here, you'... ...management, quality improvement, compliance, or claims review is a plus—but not required.Why...Remote workClaimsWork from home
$121.6k - $164.5k
Assistant Director Payment Integrity Policy & Implementation Hybrid role (3 days/week in office)... ...directs, and oversees reimbursement and coding policy activities and drives... ...legal, compliance, benefits, network, claims, operations, and strategic financeDirect...ClaimsFull timeWork at officeImmediate startWork from homeRelocationFlexible hours3 days per week$70k - $82k
...About the role The Payment Integrity Specialist ensures that the claims and payments flowing through Cityblock’s value-based arrangements are accurate, appropriate... ...intensive, analytical role that combines claims and coding knowledge, data analysis, and command of CMS and...ClaimsContract workLocal areaWork from home$110 per hour
...Psychiatric Mental Health Nurse Practitioners (... ...: Per session payment of $110 per... ...payment for 90833 coding Direct deposit... ...worry about unpaid claims No-show protection... ...rapport building, and remote crisis management)... ...session ~ Integrated Psychotherapy Add-...Remote workClaimsBi-weekly payFor contractorsPrivate practice- ...regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as... ...through understanding of payment structures, outpatient reimbursement... ...reporting standards for claims submission. Identifies... ...in Business, healthcare, Nursing or related field, or equivalent...Remote workClaimsFull timeLocal areaShift work
- Overview Capability Manager, Payment Integrity - Remote at UnitedHealthcare. This role focuses on capability management for payment integrity services... ...experience in healthcare operations - payment integrity, claim, and/or provider operations Solid proficiency in Excel and...Remote jobClaimsMinimum wageLocal area
- ...Medical Director, Clinical Payment Integrity provides clinical oversight... ...Interpret clinical documentation, claims data, coding practices, and... ...mentor clinical reviewers, nurses, coding specialists, and other... ...review capabilities. Fully Remote: This role is designated by...Remote workClaimsWork at office
- ...Are you a registered nurse ready to take your career... ...on advocacy and program integrity through compliance... ...setting to review and audit claims, supportprogram... ...vulnerable populations Remote work - enjoy the convenience... ...denial letters, reason codes, and appeal rights in...Remote workClaimsFull timeTemporary workWork at officeWork from home
$70.1k - $126.2k
...Position Purpose: Lead clinical coding compliance nurses and non-clinical team members through... ...Oversee relationships with health plans, claims, and other departments resulting in a... ...and a flexible approach to work with remote, hybrid, field or office work schedules...Remote workClaimsFull timePart timeWork at officeFlexible hours- ...RCM Client Integration Specialist Department: Revenue Cycle... ...RCM Services Location: Remote Employment Type: Full-... ...activities across RCM Operations, Coding, Billing, AR, Payment Posting, Credentialing, IT... ...Knowledge of healthcare claims, payer requirements,...Remote workClaimsFull timeContract workWork at officeWork visaFlexible hours
- ...take place by phone. For remote roles, and at our... ...technical direction for our Payments team — a critical... ...payment capabilities: integrating with and abstracting across... ...and guardrails for AI coding tools — code review... ...through fake e-mails claiming to be from the company...Remote workClaimsFull timeContract workWork at officeWorldwide
$79.5k - $132.5k
...Special Investigative Unit/ Program Integrity / CPC - Remote! Status: Full-time, permanent position... ...experience REQUIRED ~5 years of Coding experience REQUIRED ~ Candidates must... ...team, including oversight of pre-payment claim reviews, provider monitoring activities...Remote workClaimsPermanent employmentFull timeTemporary workCurrently hiringShift work$111.78k - $146.71k
...hiring a Manager, Data Mining to join our Payment Integrity team.Oscar is the first health insurance company... ...organizationExperience with healthcare claims adjudication Experience with SQL and basic SQL abilitiesMedical coding certification through AAPC (CPC, COC) or AHIMA...ClaimsFull timeWork at officeFlexible hours- ...Medical Review Nurse - Home Health Auditor Machinify... ...expertise across the payment continuum, delivering... ...primarily performs medical claims audit reviews with a... ...Payers. You will work remotely in a fast-paced and dynamic... ...ICD-10, CPT-4 or HCPCS coding. Knowledge of...Remote workClaimsWork at office
- ...Are you a registered nurse ready to take your career... ...on advocacy and program integrity through compliance... ...setting to review and audit claims, supportprogram... ...vulnerable populations Remote work - enjoy the convenience... ...denial letters, reason codes, and appeal rights in...Remote workClaimsFull timeTemporary workWork at office
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