Remote Clinical Review RN: Forensic Claims Expert
University of Minnesota School of Nursing
- Remote job
UnitedHealth Group seeks a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and analysis of hospital facility bills. The role involves documenting, researching, and identifying adjustments for payment as part of a team preparing Forensic Reviews for clients. Telecommuting is supported from anywhere in the U.S. The position requires RN or LPN licensure, 2+ years clinical experience, and 1+ year bill review experience, with strong Excel skills and regulatory #J-18808-Ljbffr University of Minnesota School of Nursing
- UnitedHealth Group is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and hospital facility... ...as part of a team preparing Forensic Reviews for clients. Role involves understanding claim review processes, medical record review...Remote jobClaims
- UnitedHealth Group seeks a Clinical Review Clinician to serve as the subject matter expert for itemized bill reviews and analysis... ...as part of a team preparing Forensic Reviews for clients. You will enjoy... ...and must understand the claim review process, clinical review...Remote jobClaims
- Optum is seeking a Clinical Review Clinician to act as a subject matter expert for itemized bill reviews and hospital facility bills. This role involves documenting... ...for payment as part of a team preparing Forensic Reviews for specific clients. Join a collaborative...Remote job
- UnitedHealth Group seeks a Clinical Review Clinician to analyze itemized hospital... ...and document adjustments for forensic reviews. Telecommute from... ...clinical experience, RN or LPN license, and bill review... ...knowledge. You will support claims through research and QA until...Remote jobClaims
- UnitedHealth Group is seeking a SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims and document determinations. This role offers telecommuting from anywhere in the U.S. while maintaining rigorous screening criteria and...Remote jobClaims
- UnitedHealth Group seeks an experienced SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims. The role requires documenting determinations and maintaining screening criteria, contributing to efficient, compliant health...Remote jobClaims
- UnitedHealth Group is seeking a SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims and to document all determinations. The role emphasizes adherence to Federal, State and client requirements in a telecommuting setting...Remote jobClaimsHome office
- 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... ...needed for payment as part of a team preparing Forensic Reviews for clients. Responsibilities include performing...Remote jobClaims
- 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 jobClaimsWork at office
- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative documentation to identify fraud... ...audit systems. The position is full-time (40 hours/week) with remote work options in Massachusetts and potential overtime....Remote jobClaimsFull timeLocal area
- Capitol Bridge seeks an experienced Claims Review Nurse to resolve healthcare claim disputes under... ...evaluate documentation, coordinate with clinical reviewers, and work with health plans,... ...and professional integrity. This remote position supports state-wide health plan...Remote jobClaims
$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting... ...applications This is a 100% remote role, and requires robust internet... ...authorization data with post-service claims validation, we're creating a transparent...Remote workClaimsFull timeFlexible hoursShift work$29 - $52 per hour
...Clinical Review Clinician Optum is a global organization... ...serves as a subject matter expert for itemized bill... ...to the preparation of Forensic Reviews for specific clients... ...understanding of the claim review process... ...Active and unrestricted RN license OR LPN in the...Remote workClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$29 - $52 per hour
...Program Integrity Clinical Compliance Auditor Optum... ...performing compliance reviews of medical and administrative... ...providers who submit claims for payment. This... ...schedule. This position is Remote in Massachusetts. You... ...~ Nurse licensure (RN or LPN) with a current,...Remote workClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- ...Optum Waste And Error Claims Investigator Optum is a global organization that delivers care, aided... ...the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review...Remote jobClaimsContract workWork at officeLocal areaMonday to Friday
- ...maintain comprehensive training curricula for clinical audit nurses and audit associates covering IPF and IRF claim review, documentation requirements, medical... ..., and structured for effective delivery in a remote environment. Training Delivery & Outcomes...Remote workClaimsFull timeWork at office
$110 per hour
...Physician - Clinical Advisor (Women's Health Expert) Los Angeles, CA (Remote) Clinical Advisor (MD/DO) National Authority... ...and DEA-required encounters Review and manage time-sensitive patient... ...receive any suspicious communication claiming to be from Midi Health, please...Remote workClaimsImmediate startShift work$69.3k - $78k
...integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government and... ...The position requires an active RN license and a minimum of five years... ...documenting findings, all in a remote work environment. This role...Remote jobClaims- UnitedHealth Group's Optum is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews and... ...as part of a team delivering Forensic Reviews for clients. This role... ...requires an associate degree, active RN or LPN license, and 2+ years of...Remote job
- ...Job Title: Clinical Review Nurse - Concurrent Review Location: Remote -Anywhere in US Shift : Tuesday - Thursday 9:30 am... ...supplemental information to resolve denial claims Assists with issues and/or... ...Licensure Required: LPN or RN, active in any state Preferred...Remote workClaimsLocal areaShift work
- ...part of UnitedHealth Group, is seeking a Clinical Review Clinician to analyze hospital facility... ...bills and document adjustments as part of forensic reviews for clients. The role offers... ...flexibility within the U.S. and requires RN or LPN licensure and clinical experience...Remote job
$65 - $95 per hour
...About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing... ...environment Educational Background Nursing education, RN/LPN/LVN qualification, BSN, MSN, or equivalent clinical...Remote workHourly payWeekly payContract workPart timeFor contractorsFlexible hours- 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... ...and identify adjustments for payment as part of Forensic Reviews for clients. This telecommute-friendly role...Remote job
- Centene Corporation is seeking a clinical professional on our Medical... ...Management/Health Services team to review prior authorization requests... .... Requires NY licensure as RN. The role emphasizes collaboration... ...effective care, with flexible remote/hybrid/work options. #J-18808...Remote jobFlexible hours
- ...Clinical Review Nurse - Remote ARC Group has multiple positions open for Clinical Review Nurses! These... ...determinations as to the validity of health claims and levels of payment in meeting... ...Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient...Remote workClaimsPermanent employmentWork at officeLocal area
- ...Registered Nurse: Review and Evaluation Are you a... ...role, you'll use your clinical knowledge outside of the... ...setting to review and audit claims, support program... ...unrestricted Registered Nurse (RN) license Strong... ...vulnerable populations Remote work enjoy the...Remote jobClaimsWork from home
- 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
- ...rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity... ...Registered Nurse (RN) license Strong clinical... ...for vulnerable populations Remote work - enjoy the convenience...Remote workClaimsFull timeTemporary workWork at office
- ...rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity... ...Registered Nurse (RN) license Strong clinical... ...for vulnerable populations Remote work - enjoy the convenience...Remote workClaimsFull timeTemporary workWork at officeWork from home
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