Remote Claims Review Nurse for Dispute Resolution
CAPITOL BRIDGE, LLC
New York, NY
- Remote job
Capitol Bridge LLC is seeking a Claims Review Nurse to support the Florida Statewide Health Plan CDR program and other state IRO programs. The role involves assessing documentation, coordinating with clinical reviewers, and drafting determinations to resolve disputes between providers, plans, and enrollees. The position requires an active nursing license, 5 years of direct patient care, and ability to work independently within stringent regulatory guidelines. #J-18808-Ljbffr CAPITOL BRIDGE, LLC
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Claims Review Nurse for Dispute Resolution in New York, NY vacancy
$75 - $85 per hour
# Claims Review Nurse (59863)Fully Remote • Remote - Remote Employees, VA 12345## OverviewPosition TypeFull Time## Description**About Capitol Bridge... ...role in the Florida Statewide Health Plan Claim Dispute Resolution (FL CDR) Program under the Agency for Health Care Administration...Remote workClaimsFull time- ...zilliontechnologies(dot)com Debit Card Dispute Resolution Specialist Duration: 6... ...in Pensacola, FL / 2 Days Remote "Work sponsorship is not... ...Job Description: To review, process and resolve Debit Card dispute claims. Research and process chargebacks...Remote workClaimsContract workLocal area3 days per week
Zillion Technologies, Inc.
Pensacola, FL1 day ago - ...com // (***) ***-**** Debit Card Dispute Resolution Specialist $25-$27/HR W2... ...onsite in Pensacola, FL / 2 Days Remote "Work sponsorship is not available... ...Job Description: To review, process and resolve Debit Card dispute claims. Research and process chargebacks...Remote workClaimsContract workPart timeLocal area3 days per week
Zillion Technologies, Inc.
Pensacola, FL1 day ago - ...Time Professional Lake Mary, FL, US Remote At Frontline Insurance, we are on a... ...Make Things Better, and our Alternative Dispute Resolution (ADR) Claim Adjuster plays a pivotal role in... ...Dispute Resolution (ADR) Claim Adjuster: Review assigned claims promptly. Formulate...Remote workClaimsFull timeTemporary workLocal area
$29 - $52 per hour
...together. The Clinical Claim Review RN will be... ...compliance. The Sr. Recovery Resolution Analyst will present... ...This position is Remote in Massachusetts. You... ...Attend and participate in dispute reviews and administrative... ...work experience ~ Nurse licensure (RN or LPN)...Remote workClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift workRegistered Nurse
Boston, MA2 days ago$80k - $95k
...Medical Review Nurse III Fully Remote Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000... ...automated and complex medical record and claim reviews to make coverage... ...medical record reviews in response to RAC disputes/disagrees with the RVC review decisions...Remote workClaimsFull timeContract workFor contractorsLive inWork at officeLocal area- ...healthcare platform, the full-time Medical Review Nurse will ensure compliance with CMS... ...and maintain data security while working remotely. Key Responsibilities Review DMEPOS orders... ...authorizations, utilization management reviews, or claim audits Proficiency with medical review...Remote workClaimsFull timeFlexible hours
Virtual Vocations Inc
United States4 days ago - ...WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to prepare timely redeterminations...Remote workClaims
WPS Health Solutions
Columbus, OH1 hour ago - Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy,...Remote jobClaimsWork from home
- ...Medical Reviewer This isn't just a job; it's an opportunity to build something that truly matters and directly shape the future of... ...-authorizations, DME utilization management reviews and/or DME claim audit processes. Standard computer literacy and proficiency...Remote workClaimsLocal areaFlexible hours
Verse Medical
United States3 days ago - ...Clinical Validation Reviewer Focused review of professional claims related to Fraud Waste and Abuse, documentation review to support services provided from... ...would provide an equivalent background. Registered Nurse (RN). License must be active and unrestricted in state...Remote workClaimsWork at office
Saviance
United States1 day ago - ...Claims Review Management Nurse (RN) We are seeking an experienced Claims Review Management Nurse (RN) to support the Pennsylvania Medicaid program... ...in Harrisburg, PA, with a hybrid schedule (three days remote, two days onsite). This position plays a critical role in...Remote workClaimsLong term contractFull timeContract workWork at office2 days per week
The CKHobbie Group
Harrisburg, PA1 day ago $2,732 - $4,682 per month
...Louisiana works for everyone. The Workers' Compensation Dispute Resolution Specialist 1/2 will provide support services to the... ...workplace safety. The department manages disputed claims, conducts hearings, reviews medical treatment disputes, and investigates fraud through...ClaimsFull timeWork experience placementWork at officeState of Louisiana
Baton Rouge, LA2 days ago$35 per hour
...Base pay range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift Position Description... ...adjudication of Federal Emergency Services (FES) 1500 claim forms. Some coordination will be required with...Remote workClaimsHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shiftAxius Technologies
Phoenix, AZ5 days ago$70k - $95k
We are seeking a remote Clinical Claims Review RN to join an established and growing clinical review team... ...role is well suited for a registered nurse with a strong ICU, emergency, or... ...clearly and accurately to support claim resolution, inquiries, and appeals Meet established...Remote workClaimsHourly payFull timeWork at officeLocal areaMonday to Friday- ...Digitech is seeking a detail-oriented Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to commercial carriers. This remote role requires reviewing pending/denied claims and following through to payment, with strong analytical...Remote workClaimsMonday to Friday
Tri-anim
Virginia, MN2 days ago - ...To support a growing team, the full-time Claims Resolution Specialist will review medical insurance claims for resolution and payment, resolve inquiries... ...to collect on open account balances while working remotely. Key responsibilities Review all medical insurance claims...Remote workClaimsFull time
Virtual Vocations Inc
United States2 days ago - ...established industry player is seeking a Medical Review Nurse to join their dynamic team in Phoenix.... ...reviewing and adjudicating medical claims, ensuring compliance with industry... ...enjoying the flexibility of a primarily remote work environment. If you are passionate...Remote workClaims
Axius Technologies
United States2 days ago $85.09k - $115k
...Position Location: Any Location / Remote Full Part/Time: Full time Job... ...Documentation, Documentation Review, Medical Billing and Coding,... ...Pennsylvania The Medical Policy Review Nurse will contribute to the... ...requirements, and claims integrity align with clinical...Remote workClaimsFull timeTemporary workPart timeImmediate startWork from homeWorldwideFlexible hours- Utilization Review Nurse Auditor (33034)# Utilization Review Nurse Auditor (33034)Fully Remote • Mount Laurel, NJ 08054## OverviewSalary Range... ...letters.* Assist in resolution of client complaints and/or... ...carriers, law firms, third-party claim administrators and government...Remote workClaimsLocal areaMonday to Friday
$29 - $52 per hour
...Clinical Review Clinician Optum is a global organization that delivers care, aided by... ...possess a comprehensive understanding of the claim review process including clinical claim... ...of care as applicable Assists with resolution of claims as needed to support negotiations...Remote jobClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area- ...Job Description Job Description The Claims Resolution Specialist is responsible for the day-... ...this position performs detailed claim reviews, researches payer requirements, corrects... ...accurately and efficiently. *This is a remote role. We are only hiring in the...Remote workClaims
Integrated Pain Management Medical Group, Inc.
Walnut Creek, CAa month ago - Gainwell Technologies is hiring a Senior Nurse Reviewer for a remote, home-based role across the continental US. The position focuses on reviewing medical claims, UB-04 forms, and itemized bills to ensure accuracy and proper billing, with emphasis on clinical review expertise...Remote jobClaimsWork from home
$78k - $99.2k
...steps. Our partner is looking for a Senior Nurse Reviewer based in the United States. Make a meaningful impact on healthcare quality and claims accuracy by applying your clinical... ...mentoring, training, and feedback. This remote opportunity combines clinical analysis,...Remote workClaimsFull timeWork from homeFlexible hours- ...leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the... ...insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing and...Remote jobClaimsFull time
- Commence is seeking a Nurse Reviewer to perform complex medical record reviews of Medicare Part A/B and DMEPOS claims. The role requires clinical judgment to assess payment validity... ...to CMS guidelines. The position is remote, offering flexibility while demanding high...Remote jobClaims
- UnitedHealth Group seeks a Clinical Review Clinician to act as a subject... ...Forensic Reviews for clients. Remote work is available nationwide,... ...responsibilities spanning claim review, medical record evaluation... .... #J-18808-Ljbffr University of Minnesota School of NursingRemote jobClaims
- ...DescriptionOverviewDigitech is seeking a Claims Resolution Specialist (Insurance Biller) to work... ...resolutions.ResponsibilitiesThis role is a remote, work from home position. The Claims... ...incorrectly paid by Insurance carriers.Review claims that have been put on hold,...Remote workClaimsWork from homeMonday to Friday
Effizotech
Dublin, OH5 days ago - Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review or related areas. You...Remote jobClaimsWork from home
- ...looking for an LTL Invoice Resolution Specialist to join... ..., reduce aging disputes, recover invalid charges... ...Responsibilities Review LTL carrier invoices and... ..., pricing, billing, claims, and accounting teams... ...Charlotte, or Chicago, with remote candidates considered....Remote workClaimsFull timeTemporary workFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Claims Review Nurse for Dispute Resolution. Be the first to apply!
Related searches
- c++ remote New York, NY
- senior devops engineer remote New York, NY
- remote .net full stack web developer New York, NY
- nursing recruiter (remote) New York, NY
- agile coach / scrum master (remote) New York, NY
- clinical data coordinator remote New York, NY
- pmp - project manager - remote New York, NY
- part time project manager remote New York, NY
- junior project manager remote New York, NY
- web developer internship remote New York, NY