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... ...including a 401(k) match and health coverage. This is a remote role with up to 25% travel expected. #J-18808-LjbffrRemote workFlexible hours- ...Nurse Reviewer At Commence, we're the start of a new age of data-centric transformation, elevating... ...with business needs and assignments. Appeal and/or claim dispute-related experience.... ...functions. This is an office/remote position. While performing the duties of...Remote workFull timeWork at officeShift work
- ...Description Provide timely review and determination of medical claims... ...prior authorization, appeals, and/or any other type of medical... ...State license as a Registered Nurse (RN),as required by contract(s... ...essential for this position Remote but need to be local to 18702...Remote workContract workFor contractorsWork experience placementWork at officeLocal area
$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$50k - $55k
...integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the Appeals Department leaders, the... ...Reviews and/or State Fair Hearing Manage and monitor all appeals... ...of frequent interruptions Remote Work Requirements High...Remote work- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records... ...The position offers a competitive salary range, remote work options, and a comprehensive benefits...Remote work
$45k - $70k
...A leading healthcare company in the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical services and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for candidates having...Remote work$40 per hour
...Nurse Reviewer 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...Remote workContract workWork at officeLocal areaImmediate start$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 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
$45k - $70k
A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote job$45k - $70k
A leading healthcare company is looking for a Utilization Management Nurse Reviewer to ensure medical services are appropriately utilized. Responsibilities include conducting assessments, reviewing patient records, and collaborating with healthcare providers. A valid nursing...Remote job- ...Documentation Integrity DRG Downgrade Specialist is responsible for reviewing, analyzing, and responding... ...detailed review, appeal preparation, and performance... ...Qualifications Bachelor’s degree in Nursing required. Minimum of 3... ...arms; kneel; talk and hear. Mental Demands: The...Remote jobWork at officeLocal area
- ...profile team, the full-time Clinical Analyst Appeals will manage clinical appeals and audit... ...commercial and government services in a remote setting, ensuring compliance with federal... ...experience and familiarity with CPT/HCPCs/DRG coding Applicable clinical or...Remote workFull time
- 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
- ...Alignment Healthcare USA, LLC is looking for a full-time California Licensed Clinical Appeals Nurse to work in a fully remote environment. In this role, you will review and process appeals for inpatient and outpatient services, collaborate with medical directors, and...Remote workFull time
$78k - $88k
...Nurse Reviewer (Registered Nurse) - Remote in US It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your...Remote workPermanent employmentFull timeContract workTemporary workMonday to FridayFlexible hours- ...healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to... ...clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist... ...practice and knowledge of Utilization Review Guidelines. The position offers a competitive...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- ...Senior Disability Hearing Attorney Mindset was founded to create a better experience... ...maximize their chances of approval. Appeals Representation: Representing clients in... ...Meticulous attention to detail is necessary for reviewing case files, analyzing medical evidence,...Remote workExtra income
- ...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
$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst... .... This position is 100% Remote. We are hiring for the following... ...cases for Medical Director Review ensuring that all pertinent information... ...Federal Services, Fair Hearing, and External Appeal through...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work$72.59k - $119.77k
...Clinical Nurse Reviewer Quality Management Saint Peter's is among the few hospitals in the world to have earned its 7th consecutive... ...software programs. Position located on-site with limited remote work hours as allowed based on Director's assessment of...Remote workFull timeWork experience placementShift work- ...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 at... ...this role, you will be responsible for reviewing pertinent patient data, developing care...Remote workFor contractors
$28 - $37 per hour
...for a Workers' Compensation Hearing Representative to deliver excellent... ...Maintaining case notes Reviewing and evaluating case files... ...assigned Workers Compensation Appeals Board (WCAB) locations Other... ...Workplace type Remote (Must reside in the state of...Remote workFull timeFlexible hours- ...Appeals Specialist We are seeking a detail-oriented and experienced Appeals... ...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
$19 - $21 per hour
...Appeals Specialist Respond to all assigned levels of denials by submitting... ...time limits. Submit external review requests and required... ...to get the denial overturned. Remote: Although this position is... ...mail them. Coordinate phone hearings with the insurance company, patient...Remote workHourly pay
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