Remote RN Claims Reviewer
Federal Hearings And Appeals
- Remote job
Federal Hearings And Appeals is seeking a Remote RN Claims Reviewer to evaluate medical claims, determine approvals, denials, and appeals. You will review medical records, apply Medicare regulations, and cite supporting documentation from the case file. Responsibilities include drafting narrative decisions, coding awareness, and maintaining professional licensure with a strong emphasis on accuracy and regulatory compliance. Travel is limited and training sessions are available as needed. #J-18808-Ljbffr Federal Hearings And Appeals
$35 - $40 per hour
...engagement, provider solutions, payment integrity, claims cost containment, and analytics. Job Title RN Utilization Management Reviewer Responsibilities Conduct timely clinical... ...Time; may require weekends. Location: Fully remote work at home role. Secure, private area with...Remote workClaimsHourly payTemporary workMonday to FridayFlexible hoursWeekend work$35 - $40 per hour
...provider solutions, payment integrity, claims cost containment, and analytics.... ...employees across 5 countries. Job title: RN Utilization Management Reviewer Job Description: We are currently... ...require weekends This is a fully remote work at home role. You must have a secure...Remote workClaimsHourly payTemporary workCurrently hiringMonday to FridayFlexible hoursWeekend work- Healing Strides Counseling seeks a qualified RN with coding expertise to review medical claims, evaluate records, and apply Medicare rules. The role involves regulatory interpretation and narrative decision writing, with attention to quality standards. The position may...Remote jobClaims
$68.64k - $72.8k
...Opportunity Overview: The RN Reviewer position is a crucial role in our organization — in... ...communication and collaboration skills across remote teams Customer-focused mindset and... ...authorization data with post-service claims validation, we’re creating a transparent...Remote workClaimsHourly payFull timeFlexible hoursShift workWeekend work- ...cases to the Medical Director for review. Refer to and work closely... ...pricing, coding, researching claims to ensure accurate application... ...Associates degree and active NYS RN license required. Bachelors... ...There may be opportunity for remote work within all jobs posted by...Remote workClaimsContract workWork at office
- ...Board Certified Physician Reviewers - Reproductive Endocrinology/Infertility Remote Networking- Physician Recruitment Contract Board-Certified Neurologist... ...HR - Corporate Hiring Full time Disability Claims QA Specialist Disability Claims QA Specialist...Remote workClaimsFull timeContract workFor contractors
- ...Working remotely, the Document Specialist will manage and streamline document workflows, ensuring accuracy, efficiency, and... ...compliance while processing and quality-checking documents and reviewing incoming claims. Key responsibilities Manage document workflows, including...Remote workClaimsWork at office
- ...seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong... ...review)Experience with DRG Validation, CDI, or claims review strongly preferredProven ability to interpret...Remote workClaims
- ...Intercare, InterMed, George Hills, and AS&G Claims Administration, we're a people-focused,... ...to clarify information.Forwards to Bill Review supervisor any unidentifiable unlisted procedure... ...in Texas but are able to work fully remote.Education and/or ExperienceHigh school...Remote workClaims16 hoursShift work
$22 - $28 per hour
...our customers. SUMMARY The Auditor reviews completed Workers’ Compensation premium audits... ...systems. Review late-reported claims identified during audits and verify whether... ...Ability to work independently in a hybrid or remote environment while managing multiple...Remote workClaimsHourly payWork at officeLocal area$82.72k - $120.63k
...We're hiring an Associate, Itemized Bill Reviewer to join our Payment Integrity team. Oscar... ...of the solutions. You will ensure claims are paid accurately and timely with the highest... ...Work Location: This position is fully remote and open to candidates residing in the U....Remote workClaimsFull timeContract workWork from homeHome office- J29 is seeking a Medical Reviewer, Coder for a temporary seasonal role in Maryland. The position... ...and complex reviews of Medicare FFS claims to assess payment accuracy and compliance... ...in a productivity-based environment, and remote-work capability across systems. Certification...Remote jobClaimsTemporary workSeasonal work
$50 - $52 per hour
A healthcare consultancy is seeking a Claims Clinical Documentation Reviewer for a part-time, remote role. The ideal candidate will possess a background in behavioral health services and a strong skill set in clinical documentation review. Responsibilities include reviewing...Remote jobClaimsHourly payPart timeFlexible hours- OpenTrain AI, Inc. seeks a Senior Claims Investigation and Evidence Review Expert for a remote, part-time contractor role. You will review CCTV, photos, statements, and reports to assess fraud indicators and causation, and to support AI training efforts. You will train...Remote jobClaimsPart timeFor contractors
- ...physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your schedule and caseload... ...: Utilizes clinical expertise, and reviews disability claims by providing an interpretation of the medical appropriateness of...Remote workClaimsFor contractorsMonday to Friday
$35 - $40 per hour
J29, Inc. is seeking a Medical Reviewer, Coder for a temporary seasonal assignment of up to six months. The role is remote, with an hourly rate of $35-$40. You will review Medicare FFS claims to identify overpayments and ensure correct payments under CMS rules. You’ll...Remote jobClaimsHourly payTemporary workSeasonal workLocal area- Devoted Health seeks a licensed dental hygienist to perform first-level clinical reviews of dental claims and pre-treatment estimates within its Clinical Operations team. You will review radiographs, charting, and narratives to ensure compliant utilization management and...Remote jobClaims
$248.92k - $311.15k
...Position Title: Physician Reviewer Location: Montebello, CA 90640 Description Grow... ...review and make recommendations on retro claims reviews for outpatient authorization, inpatient... ...accuracy of the background report. Remote Type: Remote About US: As the...Remote workClaimsLocal areaFlexible hours- ...join our Clinical Operations team as a first-level clinical reviewer for dental claims and pre-treatment estimates. You will apply ADA CDT coding,... ...high-quality care and strong provider relations. This remote, full-time role offers a competitive salary, comprehensive...Remote jobClaimsFull time
$85k - $90k
...Validation, Cost Outlier, and Readmission Reviews. Under the direction of the DRG... ...DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate... ...support coded diagnoses. This is a fully remote position. Candidates must be available to...Remote workClaims- ...Home Health Coder and Oasis Reviewer Manila Metro Manila Type... ...documentation quality and reduce claim denials Key... ...and accuracy. Preferred: RN LPN or other clinical licensure... ...Work Environment & Schedule Remote work must have secure high-speed...Remote workClaimsFull timeWork at officeWork from homeFlexible hours
- Computational Biology AI Reviewer is a remote review track for evaluating AI outputs across biology reasoning, calculations, and research workflows... ...sanity-check key derivations, calculations, or experimental claims. Flag dimensional, methodological, and citation errors with...Remote workClaimsHourly payFor contractors10 hours per week
- ...Role We're seeking a Mobile Casino Game Reviewer who is passionate about gaming and deeply... ...discover fair, fun, and mobile-first games. Remote Flexibility: Work from anywhere in the... ...potential deal-breakers. Evidence-Based Claims: Back impressions with observations (e.g....Remote workClaimsSeasonal work
- Devoted Health is seeking a licensed dental hygienist to join its Clinical Operations team as a Dental Claims Reviewer. You will perform first-level clinical reviews of dental claims and pre-treatment estimates using established guidelines and delegated authority. You will...Remote jobClaims
- Review high-dollar facility itemized bills for billing errors and policy violations. Ensure claims are paid accurately and timely with high quality. What You'll Do: Leverage coding expertise and Oscar's claim infrastructure to identify issues. Collaborate cross-functionally...Remote jobClaims
- Overjet is seeking a Board-Certified Periodontist to review dental insurance claims remotely. The role requires 5+ years of clinical experience, licensure in Florida, and familiarity with CDT codes. The position is a part-time, 1099 contractor arrangement with 5-10 hours...Remote jobClaimsPart timeFor contractors
- This role on the Complex Claims team is pivotal in managing document workflows for accuracy and compliance. You will process and quality-check documents, review claims, and ensure proper routing and status assignment. What You'll Do: Manage document workflows, processing...Remote jobClaimsWork at office
- Overjet is seeking a Board-Certified Oral Surgeon to review dental insurance claims remotely as part of our dental AI platform. This part-time, 1099 contractor role requires a Florida license and strong clinical experience. You will apply clinical expertise to assess medical...Remote jobClaimsPart timeFor contractorsFlexible hours
- ...Physician Peer Reviewer – Endocrinology Federal Hearings and Appeals Services (FHAS) is a... ...licensed to assist with independent review claims and appeals in any of the following... ...years, if performing external reviews Job Type Contract Work Location Remote...Remote workClaimsContract workWork experience placementWork at office
- ...A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Remote workClaimsFull time
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