Remote RN: Clinical Appeals & Grievances
Council Of State and Territorial Epidemiologists
The Council of State and Territorial Epidemiologists is seeking a Clinical Appeals RN to provide expertise in clinical appeals and grievances, acting as a liaison. You will analyze, review, and evaluate appeals and coordinate with medical directors. This position offers a work schedule of Monday to Friday from 8:00–4:30, with alternating Saturdays. Remote work is available from anywhere in the U.S., and a comprehensive benefits package is included. #J-18808-Ljbffr
$28.94 - $51.63 per hour
...Stryker Corporation is seeking a Clinical Appeals RN responsible for analyzing, reviewing, and evaluating appeals and grievances. This role includes solving clinical problems and... ...hour along with comprehensive benefits and remote work options within the U.S. #J-18808-...Remote workHourly pay$28.94 - $51.63 per hour
...Texas Health Institute seeks a Clinical Appeals RN to provide expertise in appeals and grievances, analyzing and resolving issues for members and providers. This role offers remote work and involves significant interaction with clinical guidelines. Qualified candidates...Remote workHourly payWork at office- ...Crains Cleveland is seeking a Clinical Appeals RN responsible for managing clinical appeals and grievances. This role requires an active RN license and a minimum of 2 years... ...clinical experience. The position allows for remote work from anywhere within the U.S., with a...Remote workHourly payMonday to Friday
- ...Minnesota School of Nursing is looking for a Clinical Appeals RN who will provide expertise in clinical appeals and grievances. This role involves analytical work with facilities... ...in Microsoft Office. The position offers remote work opportunities throughout the U.S. #J-1...Remote workWork at office
$248.5k - $373k
...UnitedHealth Group is seeking an Appeals and Grievances Medical Director responsible for reviewing and adjudicating... ...requires an MD or DO with experience in clinical practice and Quality Management.This position offers remote work flexibility, allowing for a dynamic work...Remote work- Brighton Health Plan Solutions is seeking a Clinical Appeal and Grievance Nurse to conduct clinical and benefit... .... The role requires an active RN or LPN license and at least 5 years of... ...regulatory requirements. This position is remote and emphasizes independence and...Remote job
$28.94 - $51.63 per hour
...Wisconsin Psychiatric Association Inc is seeking a Clinical Appeals RN to manage appeals and grievances effectively. This role requires a registered nurse with... ...compliance with all regulations while working remotely from anywhere in the U.S. Attractive benefits and competitive...Remote workHourly payWork at office- ...Working remotely in a full-time capacity, the RN Appeals and Grievances Specialist will manage the appeals process, review grievances, and ensure compliance with... ...responsibilities Manage and oversee the appeals process for clinical cases Review and investigate grievances to...Remote workFull time
$28.94 - $51.63 per hour
...Clinical Grievances Nurse At UnitedHealthcare, we're simplifying the health... ...the flexibility to work remotely* from anywhere in the U.S. as... ...~ Current, unrestricted RN license in the state of residency... ...management experience Clinical appeals and grievances experience...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaImmediate startMonday to Friday$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift...Remote workFull timeShift workWeekend work$28.94 - $51.63 per hour
.... Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals... ...You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWeekday work$28.27 - $50.48 per hour
...national health care organization is seeking an experienced RN for a Clinical Appeals position, responsible for reviewing medical appeals and... ...provider inquiries. This role offers the flexibility to work remotely and requires strong interpersonal and problem-solving...Remote workHourly pay$102.18k
Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition... ...requires work after hours, on weekends, holidays, a hybrid remote schedule, and occasional flexibility in hours/shift...Remote workFull timeShift workWeekend work- ...Schedule : The position is 100% Remote, and the candidates must reside in Southern... ...California Description: The Temporary Grievance & Appeals Nurse (LVN) is responsible for managing... ...outcomes. The nurse also serves as a clinical subject matter expert, providing...Remote workTemporary workWork at officeImmediate start
- A healthcare services company is seeking a Clinical Appeal and Grievance Nurse to manage medical necessity and benefit appeals. This remote role requires an active RN or LPN license and a minimum of 5 years' experience in Clinical Appeals and Grievances. Key responsibilities...Remote jobWork at office
- ...Schedule : The position is 100% Remote, and the candidates must reside in Southern California Description: The Grievance & Appeals Nurse is responsible for managing and coordinating... ...Grievance & Appeals Nurse serves as a clinical resource and subject matter expert for...Remote workWork at officeImmediate start
- L.A. Care Health Plan is hiring an Appeals and Grievances Nurse Specialist RN II in Los Angeles. This role involves assisting members with healthcare access issues and resolving complaints in compliance with regulatory standards. The ideal candidate must have an Associate...Remote job
$30.72 per hour
...Grievance And Appeals Nurse (LVN) Position Type: Full-time Schedule: Remote M-F, 8:00 am - 5 pm; Candidate Must Reside in Southern California Pay: $30.72/hr Description... ...grievance and appeals and is a resource for clinical and non-clinical Team Members in expediting...Remote workFull timeImmediate start- ...BlueCross BlueShield of Tennessee is hiring an Appeals & Grievance Nurse Analyst. This remote position involves reviewing appeals from... ...ideal candidate should have at least 3 years of clinical nursing experience and a valid RN license in Tennessee. Key responsibilities include...Remote workWork at office
- ...We are hiring an Appeals & Grievance Nurse Analyst at BCBST! In this role... ...times. You will also review clinical and medical records,... ...Note • This is a fully remote role with a 40-hour workweek... ...License ~ Registered Nurse (RN) with active license in the...Remote workShorter hoursWork at officeWork from homeRelocation package
$28.94 - $51.83 per hour
...Clinical Appeals RN Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area- ...clients, ensuring high-quality, clinically sound decision‑making. The Clinical Appeal and Grievance Nurse is responsible for conducting... ...or without notice. This is a remote role. Primary Responsibilities... ...Qualifications Active and unrestricted RN or LPN license; must maintain...Remote workContract workWork at office
$98.2k - $130.8k
VNS Health is seeking a Clinical Supervisor in New York who will oversee the Grievance & Appeals department, ensuring compliance with state and federal regulations. The role demands a Registered Professional Nurse license and at least three years of healthcare experience...$29 - $52 per hour
...have the flexibility to work remotely as you take on some tough challenges... ...initial assessment review of appeals, medical records, and CMS/... ...work independently Utilize Clinical nursing judgment assessment and... ..., valid, and unrestricted RN licensure in your state of residence...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday- Blue Shield of CA is seeking a Medicare Appeals RN Senior in Los Angeles, CA. This role involves reviewing member appeals and grievances, ensuring compliance with Medicare/National... ...for hybrid virtual work, balancing remote responsibilities with in-office requirements...Remote workWork at office
- A healthcare solutions firm is looking for a Clinical Appeals Nurse (RN) to support revenue cycle operations by reviewing denied claims. This remote position requires an active RN license and 3-5 years of clinical nursing experience. Responsibilities include assessing medical...Remote work
- BlueCross BlueShield of South Carolina is seeking a RN Appeals Analyst to join their team in a fully remote role. The analyst will handle complex appeal... ...full-time position requires an Associate's degree, clinical experience, and a valid RN license. Key responsibilities...Remote jobFull time
$80k - $90k
...Expected Hiring Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting Appeals reviews of new evidence... ...Self-starter with the ability to work independently in remote setting with minimum supervision and direction in the form...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$68.97k - $113.31k
...The Senior RN Clinical Consultant will work in partnership with Clinical and Vocational Leaders... ...in all lines of business (STD/LTD/Appeals) and products, action planning management... ...as needed Location This is a remote position with occasional travel as...Remote workFull timeVisa sponsorshipWork visaFlexible hours- ...company located in New York is looking for a Clinical Auditor to perform clinical reviews and... ...guidelines. This role requires an active RN license and the ability to analyze claims... ...documentation and reporting within the appeals process, contributing to continuous improvement...Remote job
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