Remote RN: Health Claims & Compliance Specialist

Qlarant

Qlarant is seeking a Nurse Specialist II for a full-time remote position in the United States. The role involves performing medical record and claims reviews to ensure compliance with guidelines, addressing potential overpayment, fraud, waste, and abuse in Medicare and Medicaid claims.
Ideal candidates should have a Bachelors degree, 2-4 years of relevant experience, and current RN licensure. This position offers the opportunity to contribute to healthcare quality and oversight in a dynamic environment.

#J-18808-Ljbffr

Apply

Vacancy posted 1 day ago

Similar jobs that could be interesting for youBased on the Remote RN: Health Claims & Compliance Specialist in United States vacancy

Remote QA RN: OASIS & Medicare Compliance Specialist
...Adaptive Home Health is seeking a QA RN to ensure clinical accuracy and regulatory compliance in Texas. This remote role involves reviewing OASIS assessments, coding, and collaborating with clinical leadership to enhance patient outcomes. The ideal candidate will have...
Remote work
Flexible hours
Adaptive Home Health
New York, NY
1 day ago
RN Medicare Compliance Specialist
...A company is looking for an RN Medicare Compliance-Proactive Reduction Outreach. Key Responsibilities Contact providers and attorneys to clarify documentation for Medicare Set-Aside allocations Assess individual case needs and create customized correspondence for providers...
Remote work
Work at office
Virtual Vocations Inc
United States
13 hours ago
RN - Compliance Specialist
$95k - $105k
...Position Summary RN - Compliance Specialist - Can be "remote" or "hybrid" (office/work from home) Fundamental Administrative Services, LLC is searching... ...will assist in coordinating compliance audits, claim denial/appeal response, quality monitoring, education development...
Remote work
Full time
Work at office
Local area
Work from home
Flexible hours
Fundamental Administrative Services, LLC
Fort Worth, TX
2 days ago
Remote RN: Clinical Clearance & Compliance Specialist
A leading occupational health provider is seeking a full-time Clinical Clearance Specialist Registered Nurse to work remotely. This role involves reviewing... ...processes, and ensuring compliance with health standards.... ...possess an unrestricted RN license and at least two...
Remote work
Full time
CORE Occupational Resources
Baton Rouge, LA
6 days ago
Remote RN: Medical Claims Review Specialist
...for a dedicated Registered Nurse (RN) to join its Medical Review team. This remote role involves conducting pre‑ and... ...medical reviews, ensuring compliance with clinical criteria. The ideal... ...Responsibilities include reviewing complex claims and educating teams on processes....
Remote work
Broadway-Ventures
Nashville, TN
6 days ago
Remote RN: Medical Claims Review & Appeals Specialist
A healthcare services firm based in the US is seeking a remote Medical Claim Review Nurse. In this role, you will conduct clinical reviews of medical... ...years of experience in clinical appeals review and an active RN license. This full-time position offers a structured schedule...
Remote work
Full time
Integrated Resources
Orlando, FL
4 days ago
Remote RN: Medical Claims Review Specialist
...Phoenix. This role involves reviewing and adjudicating medical claims, ensuring compliance with industry standards, and working collaboratively with... ...delivery while enjoying the flexibility of a primarily remote work environment. If you are passionate about making a...
Remote work
Axius Technologies
Phoenix, AZ
2 days ago
Remote RN Care Manager: Compliance & Audit Specialist
...A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an active PA RN license, and strong...
Remote work
IntePros
New York, NY
2 days ago
Remote RN Disability Claims Consultant
$68.97k - $113.31k
Guardian Life is seeking an RN Clinical Consultant to serve as a clinical resource for assessing disability claims. The role involves reviewing claims, collaborating with healthcare... ...to $113,310.00 and is open to candidates in the United States or fully remote. #J-18808-Ljbffr
Remote work
Guardian Life
Carson City, NV
4 days ago
Remote RN Disability Claims Consultant
$68.97k - $113.31k
Guardian Life is seeking an RN Clinical Consultant to serve as a clinical resource for disability claims assessment. You will conduct comprehensive medical reviews, analyze... ...certification preferred. This role involves remote working options and offers a competitive...
Remote work
Temporary work
Guardian Life
Baton Rouge, LA
4 days ago
Clinical Compliance Consultant/LPN/RN/LCSW/LPC - Remote in Virginia
...Multiple shifts available Overview: Sentara Health Plansis hiring a Clinical Compliance Consultant/LPN/RN/LCSW/LPC - Remote in Virginia! Status: Full-time,permanent... ...a robust provider network, including specialists, primary care physicians and hospitals. We...
Remote work
Permanent employment
Full time
Temporary work
Shift work
Sentara Health
Norfolk, VA
6 hours ago
Remote IDR Compliance & Claims Specialist
CleanPeak Energy is seeking a professional with around 3 years of experience in general insurance claims or IDR. The role involves working closely with the Legal and Compliance Manager to undertake QA across business functions and present compliance processes to...
Remote job
Work from home
CleanPeak Energy
Florida, NY
13 hours ago
Compliance Specialist 2: Zone 10
...Compliance Specialist 2 The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP...
Remote work
Work at office
Work from home
Night shift
Georgia
United States
3 days ago
Remote WORK FROM HOME / CLAIMS PROCESSOR - AT
$15.5 - $19.63 per hour
...Franciscan Health is looking for a Denial Collections Specialist to work from home in Indiana. The specialist will review denied medical insurance claims, identifying the basis for appeal and ensuring timely and compliant resubmissions. Applicants must have a high school...
Remote work
Hourly pay
Work from home
Franciscan Health
New York, NY
1 day ago
Remote Claims Compliance Audit Specialist
...Kin is looking for a Compliance Audit Specialist to join its growing Claims team, focusing on high-quality claim handling and compliance practices. The successful... ..., and identify trends to improve operations. This remote-first company values meaningful work and offers...
Remote work
Remote Jobs
New York, NY
3 days ago
Remote HIPAA & Healthcare Compliance Specialist
$70k - $100k
...A leading digital health firm is seeking a Regulatory Specialist to ensure compliance with privacy regulations, including HIPAA and HITECH. This role is crucial in supporting digital health initiatives. The ideal candidate has 3–5+ years in healthcare compliance, strong...
Remote work
Transcarent
New York, NY
4 days ago
Remote Privacy & Healthcare Compliance Specialist
$70k - $100k
...A leading digital health firm is seeking a Regulatory Specialist to ensure compliance with privacy regulations and healthcare standards. The ideal candidate will have... ...and strong knowledge of HIPAA and HITECH. This remote position offers a competitive salary range of $7...
Remote work
Transcarent, Inc.
New York, NY
4 days ago
Compliance Specialist 2 - Zone 7
$61.28k
...Type: Full-Time Salaried Remote Employment: Flexible/Hybrid... ...Department of Community Health (DCH) is one of Georgia's four... ...applicants for the position of Compliance Specialist 2, Long-term Care Unit with... ...as a Registered Nurse (RN) or a Licensed Practical Nurse...
Remote work
Full time
Temporary work
Part time
For contractors
Work experience placement
Internship
Work at office
Work from home
Flexible hours
Night shift
Georgia Department of Public Health
United States
3 days ago
Compliance Specialist 2 - SE Region
$61.28k
...Description Pay Grade: L The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the... ...currently seeking qualified applicants for the position of Compliance Specialist 2, Long-term Care Unit with Healthcare Facility Regulation...
Remote work
Full time
Temporary work
Part time
For contractors
Work experience placement
Internship
Work at office
Work from home
Flexible hours
Night shift
Georgia Department of Public Health
United States
4 days ago
COMPLIANCE SPECIALIST
...At Duke Health, we're driven by a commitment to compassionate care that changes the lives... ...Health. This position is 100% remote. All Duke University remote workers must... ...Occ Summary Implement and maintain compliance programs in accordance with the Office of...
Remote work
Work at office
Duke Clinical Research Institute
Durham, NC
2 days ago
RN Licensed CDI Appeal Consultant
...RN Licensed CDI Appeal Consultant, a fully remote position responsible for reviewing patient medical records for appeal writing, ensuring accurate documentation, and collaborating with providers and coders. Key Responsibilities Reviews medical records for appeal writing...
Remote work
Virtual Vocations Inc
United States
4 days ago
Compliance Specialist - Healthcare (Remote)
...Compliance Specialist Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ,... ...service Ability to thrive in a remote based environment, high growth,...
Remote work
For contractors
Work at office
Local area
Flexible hours
Access Telecare
United States
4 days ago
Remote Health Claims & Appeals Specialist
$17.75 per hour
...position of Appeals and Grievance Representative. This full-time, remote role involves reviewing and resolving member and provider... ...professionalism. Ideal candidates will have a strong background in healthcare claims and excellent problem-solving skills. This position offers a...
Remote work
Full time
Immediate start
Widescope Consulting and Contracting Services LLC
Powder Springs, GA
4 days ago
COMPLIANCE SPECIALIST
...Compliance Specialist Compliance Specialist at AllCare Health in the Headquarters/Telecommute department in Grants Pass, Oregon We Are Seeking A Qualified Candidate... ...to Stark Law, Anti-Kickback Statue, False Claims Act and others. Maintain a comprehensive knowledge...
Remote work
Contract work
Temporary work
For contractors
Work experience placement
For subcontractor
Work at office
Local area
Flexible hours
AllCare Health
United States
2 days ago
Remote Registered Nurse - Claims & Appeals Quality Analyst
...solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates... ...have a Bachelor's degree in healthcare and valid RN license in Florida. Key responsibilities include reviewing...
Remote work
Compunnel
Florida, NY
3 days ago
Senior Claims Reconciliation Specialist (Remote)
...American Specialty Health is looking for a Sr Reconciliation Representative to reconcile claims, including complex ones, in a remote work environment. Responsibilities include documenting comments in internal systems, making calls to health plans regarding claims, and...
Remote work
Work at office
American-Specialty-Healt
New York, NY
4 days ago
Compliance Specialist 2 - CLIA Program
$65.75k
...Description Pay Grade: L The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the... ...currently seeking qualified applicants for the position of Compliance Specialist 2 with the Healthcare Facility Regulation Division,...
Remote work
Full time
Temporary work
Part time
For contractors
Work experience placement
Internship
Work at office
Flexible hours
Georgia Department of Public Health
United States
3 days ago
Claims Specialist - Accident and Health
...Claims Specialist - Accident and Health Location: USA – MA, Marblehead; Atlanta, GA Work Arrangement: Hybrid or Remote The salary range for this role is: $76,000-125,500K The Opportunity The purpose of this role is to provide exceptional claims service...
Remote work
Full time
Part time
Work experience placement
Work at office
Work from home
QBE Insurance
Marblehead, MA
3 days ago
RN Clinical Documentation Education & Compliance Consultant
$40.91 - $68.19 per hour
...Explore and excel. At Banner Health, health care is a team effort... ...organization. This is a fully remote position and available if you... ...by CDI staff to ensure compliance with query guidelines, policies... ...Certified Clinical Documentation Specialist (CCDS) preferred within 12...
Remote work
Full time
Work experience placement
Live in
Monday to Friday
Shift work
Weekend work
Banner Health
Arizona
3 hours ago
Claims Specialist - Accident and Health
Primary DetailsTime Type: Full time Worker Type: Employee Claims Specialist - Accident and Health Location: USA - MA, Marblehead; Atlanta, GA Work Arrangement: Hybrid or Remote The salary range for this role is:$76,000-125,500K The Opportunity...
Remote work
Full time
Part time
Work experience placement
Work at office
Work from home
QBE Americas, Inc.
Marblehead, MA
5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN: Health Claims & Compliance Specialist. Be the first to apply!