Remote RN Clinical Review Specialist
Texas Health Institute
- Remote job
Optum, a UnitedHealth Group company, seeks a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and hospital facility bill analysis. You will document, research, and identify adjustments for payment as part of Forensic Reviews for clients. This telecommute-friendly role offers limited supervision within policy, HIPAA confidentiality, and opportunities to impact outcomes. You will join a diverse team with strong benefits and ongoing career development. #J-18808-Ljbffr Texas Health Institute
- ...WNS, part of Capgemini, is seeking a remote RN/LPN for utilization review in the United States. The role involves assessing medical necessity, resolving escalations, and maintaining HIPAA-compliant documentation with HealthHelp policies. Requires active nursing license...Remote workWork at office
- Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent... ...retrospective utilization reviews. This is a full-time remote role supporting Alabama contracts. You will apply...Remote jobFull time
- Optum is hiring a Clinical Review Clinician to act as a subject matter expert for itemized bill reviews and hospital facility bills. The role includes documenting, researching, and identifying adjustments needed for payment as part of a team preparing Forensic Reviews for...Remote job
- UnitedHealth Group's Optum is seeking a Clinical Review Clinician to act as a subject matter expert in itemized bill reviews and hospital facility bills. You will document and research adjustments for Forensic Reviews for specific clients. This role offers telecommuting...Remote job
- UnitedHealth Group is seeking a Clinical Review Clinician to perform forensic reviews of hospital facility bills and document adjustments with clinical accuracy. You will analyze charge details, compare to guidelines, and participate in negotiations and appeals within a...Remote job
- UnitedHealth Group is seeking a SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims, documenting determinations and maintaining screening criteria. The role supports telecommuting from anywhere in the U.S. and requires...Remote jobWork at office
$38.91 - $60.31 per hour
...and does not offer a hybrid or remote option Summary: Measures,... ...and facilitates improvement in clinical performance and outcomes.... ...licensure as a Registered Nurse (RN). Relevant certification as determined... ...and cost of living. Market reviews: All UCHealth positions are...Remote workFull timeTemporary workLocal areaFlexible hoursShift work- A health accreditation organization is seeking a Part-Time Clinical Review Specialist who will play a key role in supporting accreditation processes... ...and a background in quality assurance. This role is fully remote, allowing candidates from anywhere in the United States to...Remote workPart time
- ...Clinical Review SpecialistThe Clinical Review Specialist will assess the medical necessity and appropriateness of healthcare... ...education material required.RN license preferred.Coding Credential... ...Additional Job Details (if applicable):Remote / Work from Home.Full-time,...Remote workFull timeWork from homeMonday to FridayShift work
$63.65k - $92.57k
...Mass General Brigham. Job Summary The Clinical Review Specialist will assess the medical necessity and... ...presenting education material required. RN license preferred. Coding Credential (... ...applicable) Schedule and Work Model: Remote / Work from Home. Full-time, Monday through...Remote workFull timeWork from homeMonday to FridayShift work$63.65k - $92.57k
...Mass General Brigham. Job Summary The Clinical Review Specialist will assess the medical necessity and... ...presenting education material required. RN license preferred. Coding Credential (... ...applicable) Schedule and Work Model: Remote / Work from Home. Full-time, Monday through...Remote workFull timeWork from homeMonday to FridayShift work- ...General Brigham Incorporated in the United States is seeking a Clinical Review Specialist to assess the medical necessity and appropriateness of... ...provide clinician education to improve clinical processes. Remote/work-from-home, full-time, standard hours apply. #J-18808-...Remote jobFull timeWork from home
- ...of home healthcare services. We're seeking an experienced Clinical Review Specialist LPN to join our growing team and ensure every patient's care... ...compliance, and a compassionate touch. Position Details Location: Remote (Weekend only) On‑site Training: Orlando, FL Schedule:...Remote workPart timeWork at officeFlexible hoursWeekend work
- ..., our scalable solutions and clinical expertise help solve programmatic... ...Team Member. This is a REMOTE position within US ONLY Permanent... ...: Active, unrestricted RN license (compact preferred) Required... ...Summary The Clinical Review Specialist provides clinical review support...Remote workPermanent employmentFull timeWork at officeImmediate startMonday to FridayShift work
$81.12k
...Bpo Clinical Review Senior SpecialistNTT DATA strives to hire exceptional, innovative and passionate... ...seeking a BPO Clinical Review Senior Specialist to join our team in Jacksonville,... ...legally required benefits.Position is fully remote only in the state of Florida. Must live...Remote workPermanent employmentTemporary workLive inImmediate startRelocationFlexible hours- ...currently seeking a full time Clinical Clearance Specialist Registered Nurse to work... ...this exciting opportunity, review the job specifications below... ...Clearance Specialist (RN) is responsible for medical... ...standards. This is a fully remote position requiring strong clinical...Remote jobFull timeTemporary workWork at officeWork from homeMonday to FridayShift work
- ...healthcare accrediting organization is looking for a Full-time Clinical Review Specialist who will support the accreditation process for community... .... Strong communication skills and the ability to work remotely are essential. Traveling 15-20% will be required. #J-18808...Remote jobFull time
$35.87 - $58.37 per hour
RN - Clinical Transition Specialist Location: US-IL-Urbana ID: 2026-20622 Category: Nursing Position Type: Full-Time Remote: No Shift: Day Schedule: Full-time Weekend position | Saturday/Sunday... ...level of care Conducts case review presentations to educate peers on...Remote workFull timeWork experience placementLocal areaShift workWeekend workWeekday work- ...currently recruiting a personable and detail-oriented Full-time Clinical Review Specialist to perform the associated duties which support and... ...Must be willing to travel (15-20%) This position is 100% remote and can be located anywhere nationwide. In order to be considered...Remote workFull timeWork at office
$86.8k - $124k
...development. Summary The Clinical Policy Specialist – Itemized Bill Review is responsible for the development,... ...nursing) ~ Active, Unrestricted RN license from the United States and... ...should expect in this role Location: Remote (U.S.-based) Travel: Up to 10%...Remote workFull timeFlexible hours$76k
...now. We are currently seeking a BPO Clinical Review Specialist to join our team in Tampa, Florida (US... ...benefits. Position is fully remote only in the state of Florida. Must live... ...Licensure Active Registered Nurse (RN) license required. (Not encumbered...Remote workPermanent employmentTemporary workLive inWork at officeImmediate startRelocationFlexible hours$81.12k
...organization, apply now. We are currently seeking a BPO Clinical Review Senior Specialist to join our team in Jacksonville, Florida (US-FL), United... ...or legally required benefits. Position is fully remote only in the state of Florida. Must live in State of Florida...Remote workPermanent employmentTemporary workLive inWork at officeImmediate startRelocationFlexible hours- ...Job Description Job Description REMOTE OPPORTUNITY! BAYADA Home Health Care is seeking a remote Clinical Support Specialist (RN required) for our Home Health Senior Care team... ...for a Clinical Support Specialist: Review Oasis and Homecare Homebase 485 documentation...Remote workWeekly payLocal areaMonday to Friday
- An established industry player is seeking a Clinical Editor/Proofer Registered Nurse for a remote role in New York. This unique position blends clinical expertise... ...dispute resolutions. You'll be responsible for reviewing case documents, making necessary edits, and...Remote job
$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN... ...effectively with colleagues and prepare cases for review and appeals. Minimum Qualifications: RN, LPN, or...Remote jobFull timeMonday to FridayShift work- ...Registered Nurse (RN) Clinical Operations Specialist The Registered Nurse (RN) Clinical Operations Specialist... ...based on clinical need. Review and route laboratory results, imaging... ...Support Chronic Care Management, Remote Patient Monitoring, Transitional Care...Remote workWork at office
$81.1k - $116.48k
...authorization of or delivery of clinical and non-clinical... .... The A&G Clinical Specialist is the subject matter expert... ...This position is 100% Remote. We are hiring for the... ...for Medical Director Review ensuring that all pertinent... ...Qualifications: RN, LPN OR Dental Hygienist...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- Myaegis is hiring an Oasis / Coding Review Specialist in Mesa, AZ. This full-time role involves reviewing clinical charts, supporting quality improvement initiatives, and coaching... ...candidate has a healthcare background (LPN, RN, PT, or PTA) and must possess strong...Remote jobFull time
- Molina Healthcare is seeking a registered nurse with inpatient claim review experience to ensure diagnoses, procedures, revenue codes, and DRG assignments accurately reflect the documented care and billed charges. You will apply ICD-10, DRG and revenue code guidelines,...Remote job
$2,764 per week
...Healthcare is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in... ...Location: Beaverton, OR Assignment: REMOTE Time Zone: Must be located in the Pacific... ...: 5 years required Utilization Review or Quality Assurance: 2 years required...Remote workFull timeContract workImmediate startRelocation packageMonday to FridayShift work
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