Remote Clinical Appeals PA - Impact & Review
Council Of State and Territorial Epidemiologists
- Remote job
UnitedHealthcare, a UnitedHealth Group company, seeks an experienced Physician Assistant to join our Appeals and Grievances team. You will review and adjudicate appeals under supervision of a Medical Director, collaborating with a multidisciplinary team to ensure clinical accuracy and timely decisions. This remote, US-wide role requires NCCPA certification, an active PA license, 5+ years of practice, and proficiency in MS Office. #J-18808-Ljbffr Council Of State and Territorial Epidemiologists
- MedImpact Healthcare Systems, Inc. seeks an Appeals Clinical Specialist to lead clinical reviews, evaluate medical records, and determine benefit coverage for... ...position is based in San Diego with potential remote work per management approval. #J-18808-Ljbffr MedImpact...Remote workFull time
- ...Physician Associate to join our Appeals and Grievances team. The role involves clinical review and adjudication of appeals across... ...decision rationales. A licensed PA with NCCPA certification and 5+... ...required. The position allows remote work from anywhere in the United...Remote job
- ...Administrators, LLC, part of BlueCross BlueShield, is hiring an Appeals Analyst. This role involves researching complex appeal requests and performing clinical reviews. The job is full-time, Monday through Friday, and can be remote or on-site in Nashville, TN. Qualified candidates...Remote workFull timeMonday to Friday
- ...is seeking a Physician Associate to review and adjudicate appeals and grievances across multiple health... ...deliver timely determinations. This remote role requires a current PA license, NCCPA certification, and 5+ years of clinical practice, with strong MS Office skills...Remote jobWeekday work
$80k - $90k
...OPPORTUNITY: Expected Hiring Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting Appeals... ...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- ...seeking a Physician Assistant to lead appeals and grievances review, working under supervision of a Medical... .... Requirements include a valid PA license in your state, NCCPA certification... ...practice, and strong MS Office skills. Remote work from anywhere in the U.S. is supported...Remote job
$30 - $40 per hour
...Appeals Clinical Reviewer The Appeals Clinical Reviewer serves as an Appeals Utilization Review Nurse responsible for reviewing and evaluating... ...appropriate utilization of healthcare services. This is a remote opportunity with potential for permanent placement. Responsibilities...Remote workPermanent employmentContract workTemporary workWork at officeWork from homeMonday to Friday- CareFirst, Inc. is seeking a full-time Clinical Medical Review Nurse to work remotely. In this role, you will manage the review of professional and institutional claims and provider appeals to determine eligibility for benefits. You’ll analyze medical information to support...Remote jobFull time
$28 - $33 per hour
...Appeals Clinical Reviewer The Appeals Utilization Review Nurse reviews and evaluates member and provider appeals related to medical necessity... ...to transition to a permanent role and is performed fully remotely. Responsibilities Review and evaluate member and...Remote jobPermanent employmentContract workTemporary workMonday to FridayWeekday work$27.02 - $48.55 per hour
...everything for our 28 million members as a clinical professional on our Medical... ...Purpose: Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical... ...a flexible approach to work with remote, hybrid, field or office work...Remote workHourly payFull timePart timeWork experience placementWork at officeFlexible hours- UnitedHealthcare is seeking a Physician Associate to perform ongoing clinical review and adjudication of appeals and grievances. You will collaborate with a team of... ...PPO, HMO, MAPD, and PDP programs. The role supports remote work within the United States, with standard Monday-...Remote jobMonday to Friday
- TEEMA Solutions Group is looking for a Clinical Quality Reviewer to support a large-scale federal healthcare program in Phoenix, Arizona. This position... ...analytical skills. This role offers flexibility with remote or onsite work options, depending on business needs. #J-18...Remote job
- ...UnitedHealthcare unit seeks a Physician Associate to review and adjudicate appeals and grievances across multiple health plans. You... ...and maintain high standards of care. This full-time remote role requires state PA licensure, NCCPA certification, 5+ years of practice...Remote jobFull time
- Syneos Health in the United States is seeking an experienced Clinical Data Reviewer - Oncology to ensure data integrity for oncology trials. You... ...skills including querying and Excel proficiency. This is a remote-capable position within US/Canada. #J-18808-Ljbffr Syneos HealthRemote jobInterim role
- Beth Israel Lahey Health is seeking a Clinical Analyst to join the Patient Financial Services team and lead complex clinical appeals, audits, and compliance initiatives across inpatient... ...necessity and appropriate level of care, review coding and documentation, and educate...Remote job
- ...Occupational Medicine seeks a clinician (NP/PA) to provide telemedicine coverage and... ...leadership across California. The role supports remote triage, treatment planning, and return-to-... ...-time schedule, with options for a home clinic assignment. California NP/PA license and...Remote workHourly payFull timePart timeFlexible hours
$93.14k - $124.8k
...Manager, Patient Financial Services, the Clinical Analyst plays an important role on a high... ...handling all commercial and government clinical appeals and audit processes. The Clinical Analyst... ...involved. Assist in the tracking and review of payer audit and denial results....Remote job$50 per hour
...RN Clinical Reviewer / IDR - Remote Location: Remote Employment Type: Full-time Hourly Rate: $5... ...comprehensive medical-legal reviews and appeals for a respected non-profit... ...legal review and dispute resolution Impactful Work: Contribute to fair resolution...Remote workHourly payFull timePrivate practice- ...a career, it's a calling. WI-REMOTE Worker Type Regular Job Summary... ...concurrent analytical reviews of clinical and coding data to improve physician... ...SOI, ROM, case mix, and the impact of procedures on the billed... ...accredited school of nursing, PA, NP, or medical school, or Associate...Remote workHourly payFlexible hoursShift workDay shift
$70k - $80k
Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider appeals. Candidates must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience...Remote jobFull timeContract workMonday to Friday$112.7k - $193.2k
...Clinical Review Dentist At UnitedHealthcare, we're simplifying the health... ...care. The work you do here impacts the lives of millions of... ...enjoy the flexibility to work remotely from anywhere within the U.S... ...individual case review for appeals and grievances. The Appeals...Remote workMinimum wageFull timeWork experience placementLocal areaWeekend work$45.29 - $84.11 per hour
...Rotating weekends Hybrid/Remote Summary The purpose of... ...timely and accurate clinical information to all payers... ...resolution. Responsibilities Review all inpatient admission... ...the Physician Advisor (PA) for a second level... .... Track and trend all appeals and communicate on a...Remote workHourly payDaily paidPart timeShift workNight shiftRotating shift- ...Clinical Reviewer Position Are you passionate about using your clinical expertise to support... ...determinations? We're recruiting for 2 full-time remote/hybrid Clinical Reviewer positions.... ...or review processes. Assist with appeal case preparation for medical affairs...Remote workFull timeWork from homeMonday to Friday
- ...Clinical Appeals Nurse - Full Time Remote - Jefferson Health Reviews payor denials and audits for potential lost revenue. Writes comprehensive, factual arguments to... ...Certifications - Required ~ RN - Licensed Registered Nurse_PA - State of Pennsylvania Workday Day (United...Remote jobFull time
- ...Description Job Description Fully remote- Must have state of MI... ...concurrent and retrospective review of inpatient, outpatient, ambulatory... ...and level of care, including appeal requests initiated by... ...computer skills (Microsoft office) Clinical experience in ICU, ER, or...Remote workWork at officeFlexible hours
- ...Description: Job Title: Clinical Quality Reviewer RN (Quality of Care Review)... ...Conversion to FTE) Location: Remote - CA Work Schedule:... ...needed. Collaborate with Appeals & Grievances teams and... ...opportunity to make a direct impact on healthcare quality and patient...Remote workWork experience placementWork at officeMonday to Friday
- Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with...Remote jobWork from homeFlexible hours
$57 per hour
ProPivotal Staffing is seeking a Clinical Pharmacist Reviewer to work from home in Massachusetts. This role supports clinical pharmacy services and involves optimizing treatments with healthcare teams. Candidates should have 1-2 years of experience and an active Massachusetts...Remote workHourly payWork from homeFlexible hours- ...To support a high-profile team, the full-time Clinical Analyst Appeals will manage clinical appeals and audit processes for both commercial and government services in a remote setting, ensuring compliance with federal and state regulations related to coding, billing, and...Remote workFull time
$90k - $99k
DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes... ...Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal...Remote jobFull timeWork from homeFlexible hours
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