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
A healthcare solutions company is seeking a DRG Nurse Reviewer Appeals and Hearings to handle appeals from providers and participate in hearings. This remote position requires an active RN license and certification in coding. The ideal candidate will possess excellent communication...Remote workFlexible hours$90k - $99k
...Santa Barbara Cottage Hospital is seeking a DRG Nurse Reviewer Appeals and Hearings. The role involves coordinating and performing all appeal-related... ...5+ years of clinical experience. This position allows remote work with minimal travel and offers a pay range of $90,...Remote workFlexible hours- ...Downtown Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform all appeal-related duties, including analyzing... ...for hearings. This position is a full-time, permanent remote role that complies with work-from-home policies. The...Remote workPermanent employmentFull timeWork from homeFlexible hours
- ...Kids for the Future is seeking a DRG Appeals Review Nurse to analyze and appeal denied MS-DRG and APR-DRG accounts. The ideal candidate will have a Registered Nurse License, relevant coding certifications, and extensive clinical experience. Key responsibilities include...Remote workWork from home
- ...The Nurse Reviewer is responsible for the coordination, facilitation, and appeal of the clinical components of charge audits and forensic review findings. This includes... ...training for nursing staff. Working schedule Remote, M-F eastern standard business hours. Requires...Remote work
$50 per hour
Overview Registered Nurse Clinical Reviewer / IDR - Remote to Office-Based, Jericho, NY (ID #25302) Location:... ...medical-legal reviews, research, and appeals while ensuring regulatory compliance... ...to Office-based position, we want to hear from you! Submit your Resume/CV to...Remote workHourly payFull timePrivate practiceWork at officeFlexible hours$57 per hour
Peak Performers is hiring an Administrative Hearing Officer in the United States, fully remote. The role requires a Juris Doctor (JD) and tasks include conducting hearings and evaluating evidence. Work involves legal decisions impacting unemployment insurance claims and...Remote workMonday to Friday- ...Board Of Industrial Insurance Appeals Hearings Judge The Board of Industrial Insurance Appeals (BIIA) is offering a challenging and rewarding opportunity for the right individual to make a difference through serving the state of Washington. Our employees are our most...Remote workFull timeWork at officeFlexible hours
$41.72 - $50.99 per hour
...Blue Cross and Blue Shield of Massachusetts, Inc. is hiring a Clinical Appeals Nurse Reviewer in Hingham. This role involves responding to provider appeals for denied services, utilizing clinical judgement, coding knowledge, and collaboration with various departments....Hourly payFull time- ...sick and injured; educate physicians, nurses and other health care providers; and... ...ability to pay for health care. The CDI RN DRG Downgrades Appeals Review Specialist is responsible for the... ...information. Corrected vision and hearing to within normal range. Hearing as it...
$102.33k - $125.07k
...quality of care issues for peer review. Ensure that authorization... ...to include hospitals, skilled nursing facilities, long‑term acute... ...insurance clinical reporting. Appeals and Grievance Assemble evidence... ...cases for administrative hearings or Independent Review Entity...Remote workWork at officeLocal areaWork from homeFlexible hours- ...Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating... ...departments to promote effective outcomes in patient care, handling appeals and collaborating with physicians. Required qualifications...Remote workFlexible hours
$50 per hour
...About the Job Registered Nurse Clinical Reviewer / AIMS - Remote (#25299A) Location: Remote. Employment Type: Full-time. Hourly Rate:... ...3 years of experience in acute care utilization review/appeals background. Technical Skills: Must be comfortable working...Remote workHourly payFull time- ...Acute Coding Appeals Specialist 100% Remote | 6-Month Contract-to-Hire Medasource is... ...a strong understanding of DRG validation, denials management... ...payer denials, we want to hear from you. Position Overview... ...Specialist is responsible for reviewing inpatient coding denials...Remote workContract workMonday to FridayFlexible hours
- ...Santa Barbara Cottage Hospital is seeking a Nurse Reviewer who will conduct compliance reviews of providers to ensure adherence to state regulations... ...and an active Illinois RN license. This position allows for remote work with 2–3 on-site visits per week throughout Illinois. #J-...Remote work
$70k - $80k
...Diagnosis Related Group (DRG) Auditor III Join to apply for the... ...team! This role offers a fully remote work experience with possible... ...comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG... ...strong uphold rates for appeals. Stay ahead of industry trends...Remote workFull timeWork experience placementReliefWork from homeHome officeRelocation package$60 per hour
...organization in Jericho, NY is seeking a Full-time Registered Nurse Clinical Reviewer. This role requires a Baccalaureate degree in Nursing and... ...will have 1–3 years of experience in utilization review or appeals and strong communication skills, contributing to patient...Hourly payFull time$80k - $90k
...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible... ...with CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding may be necessary.... ...ability to work independently in remote setting with minimum... ...good standing and diversified nursing experience providing direct...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$36.27 - $56.77 per hour
...Elevance Health is looking for a Nurse Reviewer I in Walnut Creek, CA, allowing for virtual work full-time with in-person training. Responsibilities include conducting reviews for diagnostic imaging services and collaborating with healthcare providers to ensure quality...Remote workFull time- ...Elevance Health is seeking a Nurse Reviewer I to conduct medical necessity reviews for diagnostic imaging services. This role offers the flexibility of virtual full-time work, with part-time onsite requirements for training. The successful candidate should possess at...Remote workFull timePart time
$174.07k - $374.92k
...opportunity for a Medical Director. This is a remote Work at Home position and can be... ...Responsibilities transactional reviews in support of the appeal process, clinical claim review process... ...areas. be a subject matter expert in DRG reviews and ICD‑10 code selection. participate...Remote workHourly payFull timeTemporary workLocal areaWork from home- ...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 work
- ...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
$45 - $55 per hour
...Commence is looking for a Nurse Reviewer to analyze medical records and support independent dispute resolutions at federal and state levels... ...part-time position offers a flexible work environment, including remote options. The salary ranges from $45 to $55 per hour, depending...Remote workHourly payPart timeFlexible hours$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 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 reviews...Remote workContract workWork at officeLocal areaImmediate start$70k - $80k
...Gainwell Technologies is seeking a Nurse Reviewer, Associate, who will conduct clinical reviews to assess if medical records support the need for services based on defined criteria. In this home-based full-time role, you will review and interpret medical documentation...Remote workFull timeWork from home$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...Remote work$33.12 - $56.77 per hour
...Elevance Health is seeking a Nurse Reviewer I to conduct preauthorization reviews for diagnostic imaging. This is primarily a virtual role based in Washington DC, suitable for new graduates. You will collaborate with healthcare providers to ensure proper treatment approvals...Remote work
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