Remote DRG Nurse Appeals Reviewer for Hearings
$90k - $99kGainwell Technologies
A leading healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage in hearings, both virtual and on-site. Candidates must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career development. The salary range is $90,000 - $99,000 per year. Join us in making healthcare work better for everyone while enjoying generous benefits, including a flexible vacation policy and educational assistance. #J-18808-Ljbffr
$90k - $99k
...DRG Nurse Reviewer Appeals and Hearings- Remote Date: Jan 9, 2026 Location: Any city, FL, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and...Remote workFull timeWork from homeFlexible hours$90k - $99k
Gainwell Technologies LLC is seeking a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform appeal-related duties, including analyzing and... ...a 401(k) match and health coverage. This is a remote role with up to 25% travel expected. #J-18808-Ljbffr Gainwell...Remote jobFlexible hours- ...the Benefits of Working at HHS webpage. Functional Title: Nurse Reviewer Job Title: Nurse II Agency: Health & Human Services Comm... ...as the Subject Matter Expert (SME) in Medicaid fair hearings related to appealed service reductions or denials. (5%) Produces routine and...Remote workFull timeTemporary workPart timeWork at officeLocal areaWork from homeShift work
$67.32k - $133.71k
...experienced professional to work remotely from within the greater... ...PURPOSE: The Clinical Appeals Nurse completes research, basic analysis... ...the appeal case for physician review by compiling clinical, contractual... ...must frequently talk and hear. Weights up to 25 pounds are...Remote workWork experience placementWork at officeImmediate start$80k - $90k
...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is... ...with CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding may be necessary.... ...ability to work independently in remote setting with minimum supervision... ...good standing and diversified nursing experience providing direct...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$95 per hour
Long-Term Care Registered Nurse (VA Reviewer) - Remote (#25278) Location: Remote Employment Type: Contract (Case-based) Hourly Rate: Per Case Compensation... ...make a difference in the healthcare industry, we want to hear from you! Submit your Resume/CV to ****@*****.*** or...Remote jobHourly payPrice workContract workPrivate practiceWork at officeFlexible hours- ...Nurse Reviewer Contract Duration: Initial 6-months Pay: $27.50/hr on W2 Start Date: 9/8/2026 Location: Fully Remote (US Only) LPN State License must be active and in good standing for the entirety of the assignment. Be prepared to share license...Remote workContract work
$43 - $47 per hour
...Roles, MA, Phlebotomist, CNA|| Passionate ||… Home Health RN – Remote (CA License Required) Facility: Compassus Providence Home... ...Torrance, CA (5315 Torrance Blvd, Ste 169-B) Role Type: Remote Reviewer RN – Back Office Chart Review Start Date: 11/03/2025...Remote workContract work- ...Nurse Reviewer 1 Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life...Remote workFull timeWork experience placementWork at officeLocal areaMonday to FridayWeekend work
$40 per hour
...PT (20-30 hours week) – Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy...Remote workContract workWork at officeLocal areaImmediate start$80 - $100 per hour
...City and County of Denver is seeking a Hearings Officer (on-call) for the Department of Public... ...& Environment. The role conducts virtual appeal hearings, drafts recommended decisions... ...of evidence and rulings. The position is remote-based with occasional in-person hearings...Remote workHourly pay$29.7 - $31.8 per hour
...Description The Acute Coding Appeals Specialist integrates... ...is responsible for reviewing and writing appeals for... ...Diagnosis Related Group, (DRG) denials in order to... ...experiences. This is a remote position; however, candidates... ..., we would love to hear from you. We believe we...Remote workTemporary workWork at officeLocal area- ...Possibility to extend) Location: Remote, preferred Iowa.... ...No OT Responsibilities Review clinical data to... ...received Generate appropriate appeal resolution... ...for Administrative Law Hearings Maintain appeals process... ...team lead; the appeals nurse is responsible for working...Remote workContract workShift work
- Healthcare Quality Strategies, Inc. (HQSI) is seeking a Nurse Reviewer for a remote position supporting Medical Review Services. The role requires conducting comprehensive medical necessity reviews and ensuring compliance with established guidelines. The ideal candidate...Remote job
- A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal... ..., and participating in ongoing training. This is a part-time remote position, offering a flexible work environment with...Remote jobHourly payPart timeFlexible hours
- A healthcare organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The role involves... ...review experience. This position offers a chance to work in a remote setup with competitive hours. Benefits include medical, dental...Remote job
$33.12 - $56.77 per hour
Elevance Health is seeking a Nurse Reviewer I who will perform medical necessity reviews for diagnostic imaging services from a virtual setting. Candidates are encouraged to apply remotely, ensuring a flexible work-life arrangement. The role requires a nursing degree and...Remote jobHourly payFlexible hours$90k - $110k
...DRG Revenue Integrity Auditor Remote CareNational is looking for an experienced DRG Revenue Integrity Auditor ! Ideal candidates will have at... ...assignment and code sequencing. Maintain quality of reviews and make sure the true clinical picture is captured, along...Remote workImmediate startWork from home$67.5k - $95k
...or an alternative application process. Nurse Reviewer RN Full Time PA, Wilkes-Barre, PA, US... ...claims, including prior authorization, appeals, and/or any other type of medical claims... ...attendance is essential for this position. #J-18808-Ljbffr Federal Hearings And AppealsFull timeContract workFor contractorsWork experience placementWork at officeLocal area- Overview Clinical Appeals Analyst (Remote) - FTThe Clinical Appeals Analyst is... ...a comprehensive analytic review of clinical documentation and... ...an Administrative Law Judge hearing and participate in hearings... ...years’ experience as a clinical nurse in an acute care setting....Remote workFull timeLocal area
- ...Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing... ...a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence... .... Collaborate with physicians, nurses, and medical directors during case reviews...Remote workWork from home
- ...Integra Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with our Medical Director in a NCQA-compliant UM program. You will review benefit...Remote work
$36 - $40 per hour
...Norwood we’re forging our own path. We’re a remote-first staffing and consulting company... ...in your coding career. If you are an Appeals and Denials Nurse looking for a new opportunity to... ...inpatient appeals letters Responsibilities: Reviews and completes continuous daily work...Remote workPermanent employmentFull timeWork visa$30 - $40 per hour
...Hearing Representative, Workers' Compensation (Remote - Field work - Fresno, CA) Full-time Remote or On-Site: Remote Degree... ...hearings Maintaining case notes Reviewing and evaluating case files... ...to assigned Workers Compensation Appeals Board (WCAB) locations to appera...Remote workHourly payFull timeFlexible hours- ...Appeals Specialist We are seeking a detail-oriented and experienced... ...am-5pm 3 months in office then remote Benefits offered Key responsibilities include reviewing assigned insurance denials and... ...Coordinate and schedule phone hearings with insurance representatives,...Remote workWork at officeMonday to Friday
- Location: Remote (U.S.) - Must reside in or be eligible for licensure in Virginia Work Type... ...is seeking experienced Registered Nurses (RNs) to support the Transportation Security... ...Administration (TSA) Candidate Assessment and Review for Eligibility Support (CARES) program....Remote workFull timeWork at officeMonday to FridayDay shift
$19 - $21 per hour
...levels of denials by submitting appeal letters and required... ...time limits. Submit external review requests and required documentation... ...to get the denial overturned. Remote: Although this position is listed... ...and mail them. Coordinate phone hearings with the insurance company,...Remote workHourly pay- ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's... ...III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is responsible for reviewing, analyzing, and processing healthcare appeals...Remote workContract workFor contractorsFor subcontractorShift work
$238k - $357.5k
...Connecting. Growing together. Work at home!The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances... ....You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take...Remote workMinimum wageWork experience placementLocal areaWork from home- ...is a 1099 contractor position. We need a Nurse Practitioner who can provide a minimum of... ...schedule is at your discretion and completely remote. We require at least 5 state licenses... ...this role, you will be responsible for reviewing pertinent patient data, developing care...Remote workFor contractors
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