Remote Home Health RN - Medical Claims Reviewer
Broadway Ventures
Broadway Ventures is seeking a Remote Home Health RN to join their Medical Review team. The role focuses on conducting medical reviews to ensure compliance with clinical guidelines. Ideal candidates must have an active RN license and clinical experience in Home Health or Medical Review. Responsibilities include reviewing medically complex claims, providing rationale for coverage decisions, and supporting quality control activities. This full-time position promotes a collaborative environment and offers necessary equipment for remote work. #J-18808-Ljbffr
$36 - $48 per hour
...Santa Barbara Cottage Hospital is seeking a Medical Claims Clinical Review Nurse for a remote position. This role involves conducting clinical reviews of medical... ...with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote workClaimsHourly pay$60k - $63k
...Remote Home Health RN – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small...Remote workClaimsFull timeFor contractorsWork at officeHome officeMonday to Friday- ...Group is seeking a Clinical DRG RN auditor to apply MS-DRG and APR... ...overpayments in inpatient claims. You will use CMS guidelines, AHA... ...support findings. You will work remotely from anywhere in the U.S., performing high-volume coding reviews with emphasis on accuracy, compliance...Remote jobClaims
$35 - $62.5 per hour
Optum is seeking a Clinical DRG RN auditor to apply expert knowledge in auditing inpatient claims. The position offers flexibility to telecommute from anywhere within the U.S. and a range of benefits including a sign-on bonus. As part of this role, you will validate coding...Remote jobClaimsHourly payRelocation package- Sedgwick Claims Management Services Ltd seeks an RN Field Case Manager to cover Chicago, IL/Northwest Indiana with frequent travel, home-based office, and telecommuting options. The role focuses on advocating for injured workers, coordinating care, and ensuring effective...Remote jobWork from homeClaimsWork at office
- ...Managers! Must be an RN and have a minimum... ...injured workers and medical providers to... ...you will maintain a home-based office. ARE... ...making an impact on the health and lives of others, and a remote work environment that... ...’s leading risk and claims administration partner...Remote workWork from homeClaimsWork at officeRelocation package
- ...freedom of working from home, theflexibility... ...setting to review and audit claims, supportprogram integrity... ...to analyze medical records, documentation... ...Registered Nurse (RN) license Strong... ...vulnerable populations Remote work - enjoy the... ...assistance, health care services or...Remote workWork from homeClaimsFull timeTemporary workWork at office
- ...Services & Insurance RN Field Case Manager *... ...injured workers and medical providers to... ...you will maintain a home-based office. **ARE... ...making an impact on the health and lives of others, and a remote work environment that... ...'s leading risk and claims administration partner...Remote workWork from homeClaimsLive inWork at office
$2,210 per week
...able to work from home 50% of the time... ...managed health care, focused on... ...benefits, including medical, dental, vision,... ...Work-life balance. Remote/hybrid setting (... ...a second level reviewer. This individual... ...status, benefit and claim concerns, and... ...not limited to RN, LMSW, LMHC. Successful...Remote workWork from homeClaimsFull timeTemporary workPart timeCasual workWork at officeAll shiftsMonday to FridayFlexible hours- ...Description Description: The Medical Nurse Reviewer applies clinical... ...expertise to review claims, medical records, and... ...Registered Nurse (RN) license in state of... ...hospice, palliative care, home health, or case management... ...Environment 100% Remote PHI/PII...Remote workClaimsFull timeWork at officeFlexible hours
- ...Remote Case Manager RN CORE Health Networks, the recognized leader in Integrated... ...Nurse) to work from home Monday through... ...exciting opportunity, review the job... ...Insurance adjusters, Medical providers, and clinic... ..., adjuster name and claim number into Billing...Remote workWork from homeClaimsFull timeTemporary workWork at officeImmediate startMonday to FridayDay shiftAfternoon shift
- ...looking for a legitimate work from home position while serving our... ...number for interview. Medical coding is the transformation of... ...appropriate codes, and creating a claim to be paid by insurance... ...certification, an accredited registered health information administrator or...Remote workWork from homeClaimsContract work
- ...flexibility and comfort of working from home. Job Title Inpatient Coding Specialist Responsibilities... ...10‑CM and ICD‑10‑PCS coding to inpatient claims. Maintain coding quality of 95% or... ...coding in an acute care setting. Utilize remote‑based connectivity, including VPN, MFA,...Remote workWork from homeClaimsFull time
$66.58k - $142.58k
...re building a world of health around every... ...Position Summary This RN Case Manager position is 100% remote and candidates are required... ...members to evaluate the medical needs of the member to... ...and information/data review (e.g., assessments, claims, etc..) conducts an evaluation...Remote workWork from homeClaimsHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayFlexible hours- ...Remote Medical Biller & Coder (Entry-Level & Experienced) Company: Rooted... ...Location: Remote (Work From Home) Job Type: Independent... ...Cycle Management • Insurance Claims Processing • Medical... ...-10, CPT, and HCPCS codes Review documentation for coding compliance...Remote workWork from homeClaimsFull timeContract workPart timeFor contractorsFlexible hours
- ...Remote Medical Biller & Coder Rooted Talent Solutions is actively seeking... ...involving medical claim processing, coding, and administrative... ..., and eager to work from home, this could be the right opportunity... ...-10, CPT, and HCPCS codes Review documentation for coding...Remote workWork from homeClaimsFor contractorsFlexible hours
- ...Remote Medical Biller & Coder Rooted Talent Solutions is actively seeking... ...involving medical claim processing, coding, and administrative... ..., and eager to work from home, this could be the right opportunity... ...-10, CPT, and HCPCS codes Review documentation for coding...Remote workWork from homeClaimsFor contractorsFlexible hours
- ...Employee discounts Health insurance Paid... ...an experienced Medical Biller and Coder to... ...Woodlands, TX. Fully remote candidates will not... ...HCPCS coding systems • Review and audit daily... ...and submit insurance claims to payers in a... ...Flexible work from home options available....Remote workWork from homeClaimsMonday to FridayFlexible hours
$45k - $70k
...Management Nurse Reviewer plays a crucial... ...by ensuring that medical services are... ..., InterQual, or health plan specific guidelines... ...LVN/RN license from an... ...work. WORK FROM HOME TECHNICAL REQUIREMENTS... ...provided for remote workspace.... ...0,000 insurance claims annually for leading...Remote workWork from homeClaimsTemporary workWork at officeMonday to FridayShift work- ...more exclusive features. Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-... ...discrepancies in coding, reviewing and correcting rejected claims from third-party carriers, and... ...Ability to work independently in a remote environment Strong...Remote workWork from homeClaimsFull timeWork at officeShift work
- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is seeking Medical... ...- and countermeasure-related injury claims. These programs provide compensation... ...discipline OR advanced degree (e.g., NP, PA, RN). At least 3 years of experience...Remote workClaimsHourly payContract work
- ...Santa Barbara Cottage Hospital is looking for a full-time Precertification Nurse to work from home. The role involves determining medical necessity for services related to New Jersey Auto No-Fault injuries. The ideal candidate will have at least 3 years of med-surg experience...Remote workWork from homeClaimsFull time
- ...subject matter expert in medical coding and DRG... ...detailed retrospective claims reviews, provide expert-level... ...thrives in a fast-paced, remote environment and is passionate... ...within managed care, health insurance, or private... ...Independent home office work environment...Remote workWork from homeClaimsFull timeWork at officeHome office
$80k - $90k
...and efficiency to health plans. Deployed by... ...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...research, analyzes claims data, applies... ...work independently in remote setting with minimum... ...speed Internet at your home office location is...Remote workWork from homeClaimsFor contractorsImmediate startHome officeFlexible hoursShift work$61.5k - $136.1k
...performing accurate and timely medical review of regular business, state of Texas and national accounts claims suspended for medical... ...unrestricted Registered Nurse (RN) license in the state of operations... ...Transparency Statement: At Health Care Service Corporation, you...Remote workClaimsPermanent employmentContract work- ## DSNP RN Care ManagerApplyremote... ...arrangements that include remote and hybrid... .... We offer health, dental, and vision... ...state—building homes, working in food... ...opportunities to impact claims expense trends... ...the Utilization Review process... ...experience in a medical/clinical environment...Remote workWork from homeClaimsWork experience placementWork at officeFlexible hours2 days per week1 day per week
- ...Risk Adjustment Medical CoderApplyremote... ...Remotelocations: US Remote: Providence,... ...repayment. We offer health, dental, and... ...state—building homes, working in food... ...medical record reviews of Medicare Advantage... ....* Review claims data to validate... ...Registered Nurse (RN)* Bachelor’s degree...Remote workWork from homeClaimsContract workWork at officeFlexible hours2 days per week1 day per week
- A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing reports, and consulting with medical experts. Candidates must hold an MD/DO or relevant...Remote jobClaimsContract work
- ...Administrators LLC are seeking a skilled reviewer to analyze medical claims and determine coverage decisions. The... ..., and education of staff within a remote, full-time schedule aligned with CST... ...business hours. The position requires an RN license (US) or a multistate compact...Remote jobClaimsFull time
- ...Administrators LLC is seeking a qualified reviewer to analyze medical claims, determine medical necessity, and support... ...accurate data and reports. This full-time, remote role follows standard CST business hours and requires RN licensure, an associate degree, and clinical...Remote jobClaimsFull timeWork at office
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