Remote Medical Review Nurse for Home Health Audits
$78.5k - $90kPerformant Recovery, Inc.
Performant Recovery, Inc. is hiring a Medical Review Nurse for remote work focusing on auditing medical claims for Home Health services. This role involves document audits, collaboration with audit teams, and staying updated on regulatory issues. The ideal candidate will have an active RN license in good standing, with five years of home health nursing experience and strong skills in ICD-9/ICD-10 coding. The salary range for this position is $78,500 to $90,000 annually. #J-18808-Ljbffr
$84k - $100k
A leading healthcare intelligence company is seeking a Medical Review Nurse II to perform audits on medical claims for government and commercial payers. This remote position requires a minimum of five years of nursing experience and an active RN license. Responsibilities...Remote workMedical- ...Nurse Auditor Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching... ...team and maximize client savings by reviewing medical bills from a nurse perspective... ...statements, and will: Audit medical and billing records to determine...Remote workMedicalImmediate start
$80k - $90k
...and efficiency to health plans. Deployed by... ...Range: $80-90k The Medical Review Clinical Appeals... ...medical review audit work completed by... ...independently in remote setting with minimum... ...standing and diversified nursing experience... ...Internet at your home office location is...Remote workWork from homeMedicalFor contractorsImmediate startHome officeFlexible hoursShift work- Machinify is hiring a Medical Review Nurse II to perform audit reviews of medical claims for skilled nursing facilities. In this remote role, you'll work as part of a dynamic team to ensure compliance and appropriate service delivery. Responsibilities include reviewing...Remote jobMedical
- Machinify is looking for a Medical Review Nurse to perform medical claims audits for government clients. This remote position requires expertise in coding and a minimum of five years nursing experience. You will work alongside a dedicated team in a dynamic environment,...Remote jobMedical
- ...Medical Review Nurse - CMS RAC In October 2025, Machinify acquired Performant... ..., and efficiency to health plans. Deployed by over 75 health... ...Nurse - CMS RAC (Government audits) primarily performs medical... ...Commercial Payers. You will work remotely in a fast paced and dynamic...Remote workMedicalFor contractorsWork at officeShift work
$64k - $80k
It takes great medical minds to create powerful solutions... ...As a Fraud and Abuse Review Nurse- Remote at Gainwell, you can... ...clients improve the health and well-being of the... ...desk and medical record audits to verify service... ...role Remote (work from home) environment Benefits...Remote workWork from homeMedicalFull timeLocal areaFlexible hours- ...Function as a designated clinical resource to review High Cost Claimants to identify... ...coordinate with other departments such as medical and pharmacy account team to address ongoing... ...leadership. Support clinical quality audit activities under the direction of manager...Remote jobMedicalFull time
- ...DOMA Technologies is seeking a Nurse Reviewer to support independent dispute... ...This role involves analyzing medical records, providing quality assurance... ...patient care experience. This is a remote position that offers the flexibility of working from home. #J-18808-Ljbffr...Remote workWork from homeMedical
- ...Nebraska is seeking a full-time Utilization Review Nurse to ensure effective management of... ...area. Responsibilities include reviewing medical treatment requests, advocating for injured... ...position offers flexibility with work-from-home options, competitive benefits, and a...Remote workWork from homeMedicalFull timeWork at office
- ...Group is looking for a Regulatory Review Specialist (RN) to join their... ...Compliance team. The role is entirely remote and plays a critical part in supporting medical reviews and regulatory... ...care while enjoying benefits like health coverage and generous paid time off...Remote workMedical
- ...Develops Brown University Health training materials,... ...as needed. Performs audits on schedule or as... ...examples of relevant medical records, resource materials... ...with Manager to review findings from external... ...Physical Requirements: Remote work from home. Supervisory...Remote workWork from homeMedical
- ...Rehabilitation Therapy, and Nursing. Job Description This... ...is for the 2018 HEDIS audit. The role involves performing medical record reviews and data extraction for... ...to working from home four days a week, depending... ...meetings are mandatory, with remote work on other days....Remote workWork from homeMedicalWork at office
- ...Registered Nurse - Utilization Review (Nursing) Location: Aurora, CO. Location: Colorado Military Health System – Buckley AFB and Peterson AFB. Labor... .... Tele-health/work from home is not an option. Legal Authorization... ..., Ambulatory Care Nursing, Medical‑Surgical Nursing or Nursing...Remote workWork from homeMedicalContract workMonday to FridayNight shift
- ...Behavioral Health Case Manager Responsible for... ...and e-referral case review and authorization of... ...and substance abuse medical necessity criteria to... ...is full-time, fully remote (work from home) and requires some weekend... ...Bachelor's degree in Nursing, or an Associate's...Remote workWork from homeMedicalFull timeShift workWeekend workAfternoon shift
- Machinify is seeking a Medical Review Nurse II to perform medical claims audit reviews for Government and Commercial Payers. This role requires an active RN license... ...2 years of relevant experience. The position is remote, and you will be part of a dynamic, multi-location...Remote jobMedical
- ...Rehabilitation Therapy and Nursing. Job Description... ...is for the 2018 HEDIS audit, Position is responsible for performing medical record reviews and data extraction... ...migrating to working from home 4 days a week. How... ...which candidate must attend and remote other days....Remote workWork from homeMedicalContract work
- ...experienced RN for a Utilization Review role, allowing you to work from the comfort of home. In this contract-to-hire... ...treatment plans and communicate with medical teams to ensure appropriate care... ...utilization review experience and a nursing degree. Join a mission-driven...Remote jobWork from homeMedicalContract work
- ...Nurses Are you looking for a change? Want... ...able to work from home 50% of the time... ...*Must have Mental Health and/or Substance Abuse... ..., including medical, dental, vision, long... ...life balance. ~ Remote setting ROLE... ...to a second level reviewer. This individual interfaces...Remote workWork from homeMedicalTemporary workWork at officeMonday to FridayFlexible hours
$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL... ...Exception only) It takes great medical minds to create powerful... ...and in the primary home residency, active compact... ...employer match, comprehensive health benefits , and...Remote workWork from homeMedicalFull timeFlexible hours- COMAGINE HEALTH is seeking a Clinical Utilization Review Nurse (RN) for a full-time remote position, focused on medical necessity assessments in healthcare. Applicants must have a BA/BS in... ...connection is essential for this home-based position. #J-18808-Ljbffr COMAGINE...Remote jobWork from homeMedicalFull timeContract work
- Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements... ..., and the ability to work in a remote environment. Comprehensive...Remote jobWork from homeMedicalContract work
$75.77k - $113.66k
A healthcare company is looking for a Medical Management Nurse to review complex cases and utilize nursing judgment to determine medical necessity. This role offers maximum flexibility with virtual work options and involves collaborating with healthcare providers to ensure...Remote workMedical- ...a stable work from home team. This is a great... ...for a local remote position. Schedule... ...commercial, behavioral health, inpatient, etc).... ...~2 years of staff nurse experience performing... ...years of utilization review (UR) experience... ...hospital admissions for medical necessity. ~ Must...Remote workWork from homeMedicalReliefLocal areaMonday to FridayFlexible hoursShift work
- ...and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER,... ...' experience in hospital, home health, or hospice care. Clinical... ...Experience in Utilization Review or case management roles.... ...to work independently in remote settings. Must be able...Remote workMedicalFlexible hours
- ...-5pm Work Location: Remote Benefits for eligible... ...You Will Do Provide health care services regarding... ...and utilization review. Review admissions and... ...concurrent and retrospective medical necessity and/or... ...Will Need ~ Registered Nurse credentialed from the Alabama...Remote workMedical
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management... ...AFB, Colorado Military Health System Compensation: $1... ..., no telehealth/remote work Minimum Qualifications... ..., Utilization Review, or Case Management... ...Ambulatory, Case Management, or Medical-Surgical (ANCC or NCQA)...Remote workMedicalContract workImmediate startMonday to Friday- ...Case Management/Utilization Review Pre-Cert Review* Prior Authorizations... ...Stay Reviews Determine Medical Necessity per Evidence-Based... ...and billing Department of Health DRG (Diagnosis Related... ...Goals Additional Skills remote UR work CA and Medi-Cal experience...Remote workMedical
- ...Registered Nurse – Utilization Review (Remote) Contract Length: 13 Weeks (Extension Possible) Facility: Providence Medical Center Location: 4101 Torrance Blvd, Torrance, CA 90503 Shift:... ...in a hospital setting (experience in health plans or medical groups is not applicable...Remote workMedicalContract workShift work
- ...Nurse Abstractor The Suicide Mortality Review (SMR) Program, within the Arizona Department of Health Services' Office of Fatality Review, conducts multidisciplinary... ...but not limited to medical, behavioral health, law... ...a multidisciplinary remote team. Qualifications...Remote workMedicalWork at office
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