RN Clinical Claims Reviewer — Elevate Patient Care
University of Minnesota School of Nursing
CVS Health is seeking a licensed Registered Nurse to review clinical documentation, apply decision-making to post-service claims, and coordinate clinical resolutions with clinician support. The role emphasizes adherence to laws and internal workflows while training staff and identifying trends in claims for quality assurance. Ideal candidates hold a BSN, have 2–3 years of RN experience, and demonstrate strong analytical skills to assess medical claims. #J-18808-Ljbffr University of Minnesota School of Nursing
$26.14 - $56.64 per hour
...Provides support for inpatient and outpatient clinical claim review activities. Verifies that coded... ...provide quality and cost-effective member care. Essential Job Duties Reviews inpatient... ...education and experience. Registered Nurse (RN). License must be active and...ClaimsHourly payWork experience placementWork at office$31.68 - $47.05 per hour
...accurate and timely insurance claims (electronic and manual) to... ...and corrected claims. Reviews and resolves billing edits... ...thrive in our culture of patient-focused, whole-person care built on understanding, commitment... ...50 hospitals, over 1,000 clinics and a full range of health...ClaimsMinimum wageFull timeLocal areaRemote workShift work- ...Lansdale Hospital is seeking a registered nurse dedicated to patient- and family-centered care. The role emphasizes individualized care plans,... ...BSN strongly preferred within 3 years of hire, and have active RN licenses in PA or NJ. #J-18808-Ljbffr Jefferson HealthSuggested
- ...in Rolla, MO, is seeking a Registered Nurse to provide direct patient care using the nursing process, ensuring high-quality, patient-centered... ...graduation from an accredited nursing program, current MO RN license or Compact licensure, and BLS certification. GN graduates...Suggested
- ...WV is seeking a registered nurse to join the inpatient care team. The role requires an active RN license, with a multi-state eNLC option acceptable, and... ...collaborate with interprofessional colleagues and families to ensure high-quality patient care. #J-18808-Ljbffr WVU MedicineSuggestedNight shift
- Norton Healthcare, Inc. in Louisville seeks Registered Nurses to provide compassionate, patient- and family-centered care across units. The role emphasizes evidence-based practice, ongoing education, and mentoring peers within a supportive governance framework. You will...Relocation package
- ...experienced Registered Nurse to provide direct inpatient care in our hospital. You will apply the nursing process, assess patient data, and use independent judgment to deliver... .... The ideal candidate has at least 1 year of RN experience, an active RN license in-state, and...
- Beacon Orthopaedics & Sports Medicine is actively hiring a Registered Nurse (RN) in PreOp PACU to support perioperative care across the patient continuum. The role emphasizes preoperative assessment, monitoring, and collaboration with anesthesia teams to ensure safe recoveries...Hourly pay
- ...organization that has engaged in health care quality consulting and quality... ...partners to improve care delivery and patient outcomes. Our talented remote workforce... ...Position Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member...Contract workRemote work
- Position Summary: The RN Integrated Care Coordinator (UM)... ...operation of our Clinical Team and the... ...address utilization review cases. Roles and... ..., identify and elevate care quality... ...reimbursement, and claim denials/appeals.... ...accordingly that can build patient trust and...ClaimsLive inRemote workFlexible hoursWeekday work
- ...Patient Services CoordinatorCommunity Healthcare Network is seeking for a Full-Time Patient... ...performance to support seamless patient care.Responsibilities include, but are not limited... ...billing teams by identifying denied claims, revenue leakage, and accounts receivable...ClaimsFull time
$18 - $20 per hour
...related reasons. Description Patient Access Representative As a Patient... ...delivery of quality patient care, and world-class customer... ...k) with company match Yearly review for growth opportunities Tuition... ...' Compensation and Auto claim submissions. Perform other diverse...ClaimsFull timeWork at officeShift work$66.58k - $142.58k
...Integrated Care Management (ICM) Care Manager... ...-5 pm. Help us elevate our patient care to a whole... ...operating and clinical models. You can have... ...information/data review to conduct an evaluation... ...sources, such as claims, to address all... ...and unrestricted RN license in the state...ClaimsHourly payFull timeTemporary workMonday to FridayFlexible hours- ...our dedication to exceptional patient care and service. Best of... ...skills, ignite your passion, and elevate your career to unparalleled heights... ...required Insurance industry claims processing/management... ...envision establishing 10 new clinics and cultivating a team of 50+...Odd jobFull timePart timeWork at officeFlexible hoursShift work
$20.5 - $27.59 per hour
...people's lives. Working in Patient Access and as a member... ...-quality, high-value care to the patients and the... ...fully reimbursed for clinical services provided. The... ...for services on initial claim submission. Ascertains,... ...time eligibility (RTE); reviews the insurer’s response...ClaimsHourly payContract workWork experience placementWork at officeRemote workShift work- ## Patient Access Rep IApply: Pennington, NJ: Full time: Posted Today: JR111136Capital Health... ...providing progressive, quality patient care with significant investments in our... ...ensure database integrity and facilitate claims processing. Applies financial screening guidelines...ClaimsFull timeTemporary workPart timeWork at officeFlexible hoursShift work
$22 - $25 per hour
...Specialty Pharmacy services to patients with chronic and rare illnesses in need of complex care.CSI is a rapidly growing national... ...to their drug prescriptions, clinical services, billing inquiries, delivery... ...are maintained, and patients’ claims, and complaints are resolved...ClaimsWork at officeMonday to Friday- ...bigger than great eye care, we're creating careers... ...AEG, we believe great patient experiences begin with... ...appropriately and support claim preparation and submission. Run reports and review accounts to ensure all... ...experience. Coordinate with clinical and optical teams to...ClaimsFull timePart timeWork at office
$18.32 - $24.43 per hour
Patient Service Representative - Join Our Dental Care Team! Location: Baker Victory HealthCare Center... ...healthcare center team. Reviews patient accounts and evaluates... ...films and additional clinical documentation Provides... ...root causes of dental claim denials monitor denials...ClaimsFull timeWork at officeMonday to Friday- Scripps Health in La Jolla is seeking a per diem, non-benefited healthcare professional to join the Breast Care Center team. The role involves about 30% direct patient care and 70% administrative duties, including patient calls, order entry, and coordination with breast...Daily paidMonday to Friday
$17.66 - $23.74 per hour
...Centers, two PACE (Program of All-Inclusive Care for the Elderly) SeniorCare facilities,... ...in under-served areas. Job Title - Patient Service Representative Department - Case... ...coordinate with Center Managers to correct denied claims to minimize our error rate, and ensure...ClaimsHourly payTemporary workLocal areaMonday to Friday- ## Patient Care Coordinator Neurosurgery ClinicApply: Banner Staffing Svcs Mesa (525 W Brown... ...conditions.As a Patient Care Coordinator in this clinic, you will be part of our in-clinic... ...be part of a team that ensures clean claims and excellent customer service, to our patients...ClaimsWeekly payDaily paidContract workPart timeWork at officeLocal areaFlexible hoursShift work
- ...rotating shift, part-time, One Call Patient Logistics Coordinator (RN) in Tyler, TX. Why Join Us? Thrive in... ...comprised of 10 hospitals, more than 90 clinics, nearly 7,500 employees and over 1,00... ...are placed in the most suitable care setting. In addition to clinical responsibilities...Part timeRotating shift
$30 - $50 per hour
About the Role The Patient Navigator RN position is an exciting... ...integral member of our care team, you will serve... ...—providing both clinical monitoring and care coordination... ...in team case reviews, staff meetings, and... ...judgment and ability to elevate concerns promptly....Hourly payFull timeWork at officeMonday to Friday- Option Care Health, Inc. is a leading home infusion provider recruiting an Infusion Nurse... ...coordinate and deliver intermediate direct patient care in home or an infusion suite. You’ll... ...s plan of care. The role requires current RN licensure, CPR, and at least 1 year of nursing...
- Baystate Health in Massachusetts is seeking nursing professionals. Positions require a nursing diploma, MA RN licensure, and BLS certification. Compensation is provided based on a system-wide range and may vary by position and experience. Salary is presented as hourly...Hourly pay
- ...join our award-winning team. This onsite, full-time role focuses on accurate billing, claims processing, and patient balance management, ensuring patients can access affordable care. Ideal candidates have at least 2 years in dental billing, strong Dentrix knowledge, and...ClaimsFull time
$121.12k - $197.58k
Clinical Documentation Specialist RN page is loaded## Clinical Documentation Specialist RNlocations... ...of a team built on trust that cares for each other, our patients and our communities. Belonging... ...hospital setting* Utilization review and/or clinical documentation specialist...Contract workLocal areaRemote workShift work$23 - $30 per hour
...touch through the delivery of high-quality care and exceptional service. As a leading... ...mission to enhance the well‑being of our patients and residents while making a meaningful impact... ...degree or equivalent. Experience in claims, billing and medical records is preferred...ClaimsTemporary work- ...engaged in providing excellence in patient care, embracing multi-disciplinary... ...20+ hospitals, outpatient clinics, ambulatory care centers and... ...care, identify and elevate potential service delays, and... ...pre-certification, and payment review Identify potential delays or...
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