Remote Clinical Appeals RN for Medicare/Medicaid
$29 - $52 per hourTexas Health Institute
- Remote job
Texas Health Institute is seeking a motivated RN to assess appeals and medical records, ensuring coverage and billable criteria. This role offers remote work flexibility, primarily within EST and CST hours. The candidate should have a valid RN license, 2+ years of clinical experience, and understanding of Medicaid and Medicare appeals. A comprehensive benefits package is included along with competitive hourly pay ranging from $29.00 to $52.00. #J-18808-Ljbffr Texas Health Institute
$29 - $52 per hour
UnitedHealth Group is seeking a Remote Registered Nurse (RN) in California to handle appeals and medical record reviews. The... ...and have at least 2 years of clinical experience. This role also requires familiarity with Medicare and Medicaid services and will involve prioritizing...Remote jobHourly pay$29 - $52 per hour
UnitedHealth Group is seeking a Clinical RN to conduct appeals assessment and care reviews. This role offers the flexibility to work remotely, adhering to Eastern or Central Standard Time. Candidates must have valid RN licensure and at least 2 years of clinical experience...Remote jobHourly pay$29 - $52 per hour
...you will perform initial assessments of appeals and manage records. This role offers a flexible remote option, with a schedule primarily from 8... ...or CST. You're expected to have a valid RN license, along with 2+ years of clinical experience and familiarity with utilization...Remote jobHourly payFlexible hours$80k - $90k
...0-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting... ...and an understanding CMS, Medicaid and/or Commercial insurance... ...to work independently in remote setting with minimum supervision... ...or excluded from the Medicare program by OIG. Must have...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$29 - $52 per hour
...flexibility to work remotely as you take on some tough... ...assessment review of appeals, medical records, and... ...Utilize Clinical nursing judgment assessment... ...valid, and unrestricted RN licensure in your state... ...Review ~ Medicaid and/or Medicare appeals experience...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday$67.3k - $93.05k
Acentra Health, located in North Carolina, is seeking a Clinical Assessor to perform eligibility assessments for Medicaid beneficiaries. This role includes conducting needs-based assessments using state-approved tools while ensuring client privacy. The ideal candidate should...Remote job$67.3k - $93.05k
Acentra Health, LLC is seeking a Clinical Assessor for a hybrid role, operating primarily in... ...will hold a valid NC or Compact RN license and have a minimum of two years of... ...Responsibilities include conducting assessments for Medicaid programs and ensuring beneficiaries...Remote job$28.94 - $51.83 per hour
Texas Health Institute is hiring a Clinical Appeals RN to represent MassHealth at appeal hearings and perform clinical coverage reviews. The successful candidate must have an unrestricted RN license in Massachusetts and at least 3 years of managed care or clinical experience...Remote jobHourly pay- Remote Jobs is seeking an experienced clinical appeals specialist to join their team. The role requires a Registered Nurse (RN) with at least one year in ICU or demonstrated proficiency in appeals writing for hospital services. You will review denials, conduct research...Remote work
$71.59k - $116.48k
...prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case... .... The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job- ...for a detail-oriented Registered Nurse Clinical Auditor to support medical record reviews... .... The ideal candidate should have an RN license, coding certification, and at least 1 year of Medicaid claims review experience. This remote position requires occasional travel within...Remote job
- Inside Higher Ed is seeking a Clinical Financial Case Manager - RN to handle clinical appeal services and complex patient account reviews. This role requires strong... ...of relevant experience. This position will be remote and focuses on developing strategies to prevent denial...Remote job
- ...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
$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... ...leadership as needed Location This is a remote position with occasional travel as...Remote workFull timeVisa sponsorshipWork visaFlexible hours$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... ...Utilization Management experience Appeals Experience Medicare/Medicaid experience preferred Proficient with Microsoft Office...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area$45.29 - $84.11 per hour
...care for the better. Hybrid/Remote Summary: The purpose of the... ...providing timely and accurate clinical information to all payers,... ...# Tracking and trending all appeals and communicating on a daily/regular... ...field Required: Current RN License in Connecticut and New...Remote workHourly payDaily paidPart timeShift workNight shiftRotating shift$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit... ...authorization of or delivery of clinical and non-clinical... ...This position is 100% Remote. We are hiring for the... ...Minimum Qualifications: RN, LPN OR Dental... ...InterQual, Milliman or Medicare local coverage guidelines...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- ...looking for a qualified candidate to manage prior authorization requests within clinical practice. This role requires at least three years of clinical experience, one year of Medicaid/Medicare experience, and an active Arizona nursing license. You will ensure accuracy...Remote job
$66k - $68k
...—A health solutions company is seeking an Appeals Nurse to examine medical records and claims... ...000-$68,000 depending on experience, with remote work options available in several states. Excellent communication skills and clinical knowledge are essential for success in...Remote job- ...company is looking for an Appeals Nurse to examine medical records... ...and compliance with Medicare guidelines. The ideal candidate... ...a nursing degree, active RN license, and experience in a clinical setting. Benefits include competitive pay, remote work options, and health insurance...Remote job
- ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~... ...our dedicated team in a remote capacity. The Appeals Processor... ...appeals related to Medicaid or Medicare coverage decisions. This... ...reviewing medical documentation (clinical roles may require RN)...Remote workContract workFor contractorsFor subcontractorShift work
- ...Role Snapshot The Appeals Nurse examines... ...necessary and meet Medicare coverage guidelines... .... The Appeals RN works in collaboration... ...We are open to remote work in the following... ..., coding, and clinical information are provided... ...for Medicare & Medicaid Services (CMS) contract...Remote workContract workFor contractorsLocal areaImmediate start
- 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 job
- ...for Career Enhancement is seeking an Appeals Nurse Consultant to join our remote team. This critical role involves... ...ensuring fair and accurate resolution of clinical appeals through sound clinical... ...candidate will possess a valid RN license, 3+ years of clinical experience...Remote job
- ...Quality Improvement Stars Clinical RN Community Health Choice, Inc... ...with the following programs: Medicaid State of Texas Access Reform... ...Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs... ...CAHPS, HOS, complaints, and appeals). Monitor Star Ratings measure...Remote workWork experience placementWork at office
$248.5k - $373k
UnitedHealth Group is seeking an Appeals and Grievances Medical Director responsible for reviewing and adjudicating... ...role 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 job$67.3k - $70k
...technology, services, and clinical expertise. Our mission... ...is looking for a RN Clinical Assessor to join... ...eligibility assessments of WV Medicaid recipients seeking... ...West Virginia, combining remote work from home with... ...change of status, mediation/appeals, reconsideration review...Remote workWork at officeLocal areaFlexible hours$92k - $96k
...compliance with Centers for Medicare & Medicaid Services (CMS)... ...This role focuses on clinical quality, patient safety... ...CT and 2 days working remotely. Key Responsibilities... ...ADRs, denials, and appeals processes Lead quarterly... ...~ Active Connecticut RN license required ~2-...Remote workFull timeWork at office3 days per week- ...Appeals Analyst We are currently hiring for an Appeals Analyst to... ...Additionally, you will provide thorough clinical review or benefit analysis to... ...: An active, unrestricted RN license from the United States... .... MCS System Knowledge. Medicare Part B. CMS Knowledge....Remote workFull timeFor contractorsCurrently hiringWork at officeLocal areaMonday to Friday
- The Hispanic Alliance for Career Enhancement is seeking a Clinical Pharmacist for a remote position. This role focuses on reviewing Medicare-Medicaid coverage determinations and involves responsibilities like drug utilization reviews and supporting clinical programs. Candidates...Remote job
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