Nurse Reviewer
Healthcare Quality Strategies
A 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 active RN license, along with experience in medical record review. Responsibilities include evaluating claims against standards, documenting results, and participating in ongoing training. This is a part-time remote position, offering a flexible work environment with competitive hourly pay. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Nurse Reviewer in United States vacancy
$95k - $110k
...Sign-on bonuses are available for highly qualified candidates. Summary We are seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing and responding appropriately to appeals...SuggestedFull timeRemote workWork from homeRelocation packageFlexible hours$40 per hour
...PT (20-30 hours week) – Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy...SuggestedContract workWork at officeLocal areaImmediate startRemote workHQSI
Tampa, FL3 days ago- ...AnalystsWe are seeking medical analysts with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications. Candidates will...Suggested
Verisk Analytics
Woburn, MA2 days ago - ...Nurse Reviewer Contract Duration: Initial 6-months Pay: $27.50/hr on W2 Start Date: 9/8/2026 Location: Fully Remote (US Only) LPN State License must be active and in good standing for the entirety of the assignment. Be prepared to share license...SuggestedContract workRemote work
Tailored Management
United States1 day ago - ...purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.? Requirements The Nurse Reviewer performs complex medical record reviews of Medicare Part A/B and DMEPOS claims that require clinical judgment in order to assess...SuggestedContract workFor contractorsLocal areaRemote work
Commence Corporation
Brooklyn, NY17 hours ago - ...Associates and 7 years of experience At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. Current/Active Nursing or Physical Therapy license...Remote workNight shift
Peraton
New York, NY1 day ago - ...UM Nurse ReviewerUnder the guidance of the Utilization Management, the UM Nurse Reviewer will leverage expertise to conduct timely reviews of pre-certification and/or concurrent requests, aligning with established policies. The UM Nurse Reviewer holds responsibility for...Immediate start
Universal Healthcare MSO, LLC
Bakersfield, CA2 days ago - ...Utilization Nurse Reviewer The Utilization Nurse Reviewer functions within the assigned area and is responsible and accountable for the coordination and efficiency of care for a culturally diverse adult and geriatric veteran population. The Utilization Management Nurse...Permanent employmentImmediate startRemote workRelocation packageMonday to Friday
- The NYC Department of Social Services is recruiting for a Supervisor of Nurses I to function as a Complex Medical Case Reviewer. You will conduct medical reviews, calculate Medicaid liens, consult records, and draft correspondence. You may negotiate repayments and testify...
$45 - $52 per hour
Overview Job Title: Registered Nurse (RN) Case Management Reviewer/Service Coordinator Company: Acro Service Corp Duration: Through June 30, 2027 (With possible extension) Hours: 7:45 am - 4:30 pm, Monday through Friday. Flex time may be approved by supervisor. Base pay...Work at officeMonday to FridayFlexible hours$43 - $47 per hour
...Facility: Compassus Providence Home Health - LA County South Location: Torrance, CA (5315 Torrance Blvd, Ste 169-B) Role Type: Remote Reviewer RN - Back Office Chart Review Start Date: 11/03/2025 Duration: 13 Weeks Pay: $43-$47/hr Job Overview: Review and process chart...Contract workRemote work- ...Utilization Management Nurse Reviewer The Utilization Management Nurse Reviewer Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. Demonstrates leadership in delivering and improving...
- 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 according to CMS guidelines. The position is remote, offering flexibility while demanding...Remote job
- Peraton’s SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a US nursing license, have 5+ years...Remote job
- Martin's Point Health Care is hiring a HEDIS Nurse Reviewer to perform clinical data reviews and ensure HEDIS compliance. The role requires nursing expertise and experience in quality improvement, with collaboration across care teams and physicians. Responsibilities include...
- ...Clinical Nurse ReviewerAs one of the fastest growing Independent Physician Associations in Southern California, our organization offers... ...is our success.We currently have an opening for Clinical Nurse Reviewer. The Clinical Nurse Reviewer will specifically run analysis on...Work experience placementFlexible hours
Care Navigators On Demand
Glendale, CA2 days ago $59k - $75.05k
...Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments...Full timeWork at officeLocal areaFlexible hoursZelis
Plano, TX4 days ago- ...This is a 1099 contractor position. We need a Nurse Practitioner who can provide a minimum of 20 hours per week of consulting services... ...a cover letter. In this role, you will be responsible for reviewing pertinent patient data, developing care plans, recommending modifications...For contractorsRemote work
Tapestry
New York, NY2 days ago $60 per hour
...Job Description Job Description Registered Nurse Clinical Reviewer / IDR – Jericho, NY (#25154C) Location: Jericho, NY Employment Type: Full-time Hourly Rate: $60/hr (based on experience) About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing...Hourly payFull timePrivate practiceFlexible hoursGreenlife Healthcare Staffing
Jericho, NY5 days ago- ...The Legal Nurse Consultant acts as an expert clinical and educational resource to clients by providing real-time advice on their cases... ...cases so our team can find the best experts Perform real-time chart reviews with a focus on standard of care and physician documentation for...
Expert Institute
Milwaukee, WI1 day ago - ...Hall Booth Smith, P.C. is currently accepting resumes for a Legal Nurse Consultant. Please note that this position requires regular... ...clinical setting. Applicants should be experienced with medical record review and dealing with expert witnesses. Experience with nursing home...Work experience placementWork at officeFlexible hours
Hall Booth Smith, P.C
Augusta, GA1 day ago $40 - $45 per hour
...Legal Nurse Consultant, Medical Chronologies Remote. We are seeking exceptional medical professionals dedicated to upholding the... ...Assurance: Your primary responsibility in this position will be to review our AI‑generated Medical Chronologies to ensure the highest...Hourly payFull timeContract workRemote workDowntown Boulder Partnership
New York, NY3 days ago- ...A national trial recruitment firm is seeking a Legal Nurse Consultant in Houston, Texas. The selected candidate will leverage extensive healthcare expertise to assist legal cases rather than traditional patient care. Responsibilities include preparing medical chronologies...Remote work
Quest Group Executive Search and Staffing Solutions
Houston, TX4 days ago - ...seeking an experienced paralegal to join our Las Vegas office. The Nurse Consultant will be responsible for providing their medical... ...Assists attorneys in the preparation and defense of medical issues Reviews, analyzes, and summarizes case files, medical records, and other...Work at officeLocal area
Freeman Mathis & Gary
Lexington, KY2 days ago - ...Quest Group is actively recruiting for a Legal Nurse Consultant for a national trial firm! Ideally an LNC with previous clinical experience... ...for cases. Identify, screen, and facilitate expert witness reviews and case evaluations, including causation and damages issues. Locate...Remote work3 days per week
Quest Group Executive Search and Staffing Solutions
Houston, TX1 day ago - ...Legal Nurse Consultant- Independent Contractor or Remote Employee - Coury, Krolls, Dean & DaPena, an Arizona based law firm, currently... ...subject areas; Identify, request via authorization and/or subpoena, review and analyze all pertinent medical records, radiology studies and...Full timeFor contractorsWork at officeRemote work
City of Plant City
Brooklyn, NY2 days ago - ...valued and empowered, then we invite you to apply to our Legal Nurse Consultant position in our Houston Office. This position offers... ...experience with a national law firm. Key Responsibilities: Order, Review, identify, and organize relevant medical records Prepare chronologies...Work at officeFlexible hours
- ...Nursing Triage AI Reviewer is a remote clinical-review track for evaluating AI outputs that touch nursing. Reviewers grade differential reasoning, dosing logic, and guideline adherence; flag patient-safety issues; and document the corrected clinical reasoning so the modeling...Remote jobHourly payFor contractors10 hours per week
- Early, Lucarelli, Sweeney & Meisenkothen, LLC. is an asbestos plaintiffs’ law firm serving mesothelioma and lung cancer victims. ELSM is seeking a client service/patient advocate to assist in new client acquisition and existing client services. This unique position combines...Full timeWork from homeFlexible hours
- Legal Nurse Consultant job at UB Greensfelder LLP, Saint Louis, MO. We are seeking a full-time Legal Nurse Consultant in our St. Louis... ...issues of a case or claim. Provide pertinent medical literature reviews. Review, summarize and analyze medical records and other pertinent...Full timeTemporary workCasual workWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Nurse Reviewer. Be the first to apply!
