Remote Registered Nurse - Claims & Appeals Quality Analyst
Compunnel Inc.
A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor's degree in healthcare and valid RN license in Florida. Key responsibilities include reviewing appeal cases, conducting audits, and collaborating with clinicians. This position offers the opportunity to work in a dynamic environment focusing on continuous improvement. #J-18808-Ljbffr
- Overview Job Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working hours: Day... ...Subcon Pay Rate: Negotiable Position Description The Quality Analyst is responsible for ensuring the accuracy,...Remote workClaimsContract workDay shift
- Description Role Snapshot The Appeals Nurse examines medical records and claims information for first-level appeal... ...Work Location We are open to remote work in the following approved states... ..., are responded to within CMS quality and timelines standards. Minimum...Remote workClaimsContract workFor contractorsLocal areaImmediate start
- Registered Nurse (RN) Clinical Denials and Appeals United States Job Description Inova 8095 - Fairfax... ...role will be Full-Time Remote, Monday-Friday (8-Hours... ...healthcare leader in safety, quality and patient experience.... ...: Reviews denied claims to identify the appropriateness...Remote workClaimsFull timeMonday to FridayFlexible hours
- WPS Health Solutions is hiring an Appeals Nurse to review medical records and claims for first-level Medicare appeal cases to determine medical necessity and compliance with coverage guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations...Remote jobClaims
- WPS Data Logistics, Inc. in Madison, WI is seeking an Appeals Nurse to review medical records and claims information for first-level appeal cases. You will determine medical necessity and ensure timely redeterminations in collaboration with Appeals Examiners and Representatives...Remote jobClaims
- Inova Health System is seeking a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team as a Full-Time Remote role. The position supports review of denied claims, development and submission of timely appeals, and collaboration across UR, Coding, Billing...Remote jobClaimsFull time
- WPS Health Solutions seeks an Appeals Nurse to review medical records and claims information for first-level appeal cases to determine medical necessity and adherence to Medicare guidelines. The RN will collaborate with Appeals Examiners to ensure timely redeterminations...Remote jobClaims
- ...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 ensure compliance with CMS guidelines. A registered nurse with strong communication and attention to...Remote jobClaims
- WPS, a health solutions company, is seeking an Appeals Nurse to review medical records and claims for first-level Medicare appeal cases, ensuring medical necessity... ...with CMS rules and company policies, while enjoying remote-capable work options. #J-18808-Ljbffr WPS—A health...Remote jobClaims
- WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level Medicare redeterminations to determine medical necessity and coverage alignment. You will collaborate with Appeals Examiners/Reps to ensure timely, accurate determinations...Remote jobClaims
$36 - $40 per hour
...forging our own path. We’re a remote-first staffing and... ...coding career. If you are an Appeals and Denials Nurse looking for a new opportunity... ...representatives to resolve claim issues. Identifies, reviews... ...“Nurse” roles. Telehealth Registered Nurse- REMOTE September 202...Remote workClaimsPermanent employmentFull timeWork visa$45k - $70k
...The Utilization Management Nurse Reviewer plays a crucial role... ..., control costs, and maintain quality care. \3 Key Responsibilities... ...equipment and a media stipend for remote workspace. Company... ...process over 200,000 insurance claims annually for leading national...Remote workClaimsTemporary workWork at officeWork from home- ...Idaho—where nationally recognized quality meets small-town heart. We’re... ...The Clinical Denial Appeals Coordinator supports the Revenue... ...visual acuity to review detailed claim and medical record information... ...Minimum: Licensed Practical Nurse (LPN) or three (3) years of clinical...Remote workClaimsWork at office
- ...Clinical Appeals Nurse - Full Time Remote - Jefferson Health Reviews payor denials and audits for potential... ...third-party payors to appeal denied claims. Works closely with Physician... ...Certifications - Required ~ RN - Licensed Registered Nurse_PA - State of Pennsylvania...Remote jobClaimsFull time
- ...as hybrid, onsite or remote. While the majority of... ...to: Customer Service, Claims Processors, and Correspondence... ...member and provider appeals, grievances,... ...healthcare field of study or Nursing Diploma (Applies to... ...a compact state as a Registered Nurse (RN) Required Certifications...Remote jobClaimsContract workWork experience placement1 day per week
$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist... .... The specialist may also handle clinical claim appeals from providers. This position is 10...Remote jobClaimsFull timeMonday to FridayShift work- CU Medicine in Aurora, Colorado, is seeking a Medical Claims Denial & Appeals Specialist. This role is crucial in resolving insurance claim denials... ...in coding is preferred. The position is fully remote, offering flexibility and valuable benefits. #J-18808-Ljbffr...Remote jobClaims
$29.7 - $31.8 per hour
...experience The Acute Coding Appeals Specialist integrates medical... ...billing/coding issues, and quality concerns. Under indirect supervision... ..., spreadsheets, account, and claim examples of root cause issues.... ...experiences. ~ This is a remote position; however, candidates...Remote workClaimsTemporary workWork at office$21 - $25 per hour
...Appeal And Grievance CoordinatorOne of Airetel Staffing's valued clients... ...position will involve claims research and processing (more... ...and the internal appeal process remote M-F (8-hr shift that will start... ...CMS) and National Committee for Quality Assurance (NCQA). At least 1...Remote workClaimsShift work$73.35k - $113.25k
...The Payment Integrity Analyst (Team Lead) assists with... ...reviewing pre and post pay claim audits based on client,... ...of internal auditing, appeals of pre and post payment... ...record that requires quality review to determine... ...policies. This is a remote position. ESSENTIAL...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours- Remote Position Scope of Position After inpatient medical... ...the Inpatient Coding Quality Analyst serves as a subject... ..., resolves inpatient claim and coding edits,... ...denial prevention and appeal activities, and collaborates... ...required: Registered Health Information Administrator...Remote workClaimsWork at office
- ...Quality Analyst Review teams' production for errors and inaccuracies. Document and publish quality scores. Council and mentor team members... ...and AR follow-up. ~ Thorough understanding of provider claim life cycle. ~ Thorough knowledge of major insurance payers....Remote workClaims
- ...Description Seeking a Registered Nurse (RN) – Expert Medical... ...schedule (three days remote, two days onsite). This... ...medical record reviews, claim evaluations, and... ...fraud, waste, abuse, or quality concerns. The nurse... ...responsibilities include supporting appeals and follow-up reviews,...Remote jobClaimsLong term contractFull timeContract work
- ...Management Enterprises (PME) seeks a Grievance & Appeals Coordinator I to analyze and resolve verbal and written claims and appeals from providers and pursue resolution of formal grievances from members. This remote in Indiana position requires a high school diploma...Remote workClaims
- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members... ...1+ year of Medicare Appeals and Grievance or Medicare Claims experience required Experience with Medicare Part C or...Remote workClaimsFull time
$81.4k - $145k
...organization, apply now.We are currently seeking a Quality Analyst to join our team in Montgomery, Alabama... ...in Montgomery Alabama. This can be a remote position with limited travel to the... ...in Medicaid domain knowledge related to Claims processing and preferably claims data...Remote workClaimsTemporary workFor contractorsWork experience placementWork at officeFlexible hours- Allied Benefit Systems is seeking an Appeals Specialist responsible for organizing and completing all claim appeals in the Appeal Department. The role emphasizes accurate documentation and timely processing from a remote-friendly environment. You will review appeals, validate...Remote jobClaims
- Mercor is seeking a Denials Management & Appeals Manager to lead operations focused on managing claim denials and appeals processes. This role requires extensive... ...effective appeal strategies. This position is fully remote and offers competitive compensation. #J-18808-...Remote jobClaims
- ...Technical Denials & Appeals Specialist Our client is seeking a sharp, analytical, and... ...record of diving deep into physician billing claims, uncovering why they were rejected, and... ...them, we want to talk to you. This is a remote opportunity. However, candidates must reside...Remote workClaimsWork at office
$24 per hour
...The Claims Quality Assurance Analyst is responsible for monitoring and documenting production quality in... ...clean claim submission, edits, denials, appeals, payment posting/reconciliation) across... ...development opportunities Remote Opportunities We are actively seeking...Remote workClaimsHourly payFull timeTemporary workLocal areaFlexible hours
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