Remote Clinical Claim Review RN — Coding & QA Expert
Texas Health Institute
- Remote job
Texas Health Institute is hiring a Clinical Claim Review Nurse to perform claim reviews, ensuring correct coding and charges. Telecommute from anywhere within the U.S. while making a direct impact on patient care. The ideal candidate possesses an Associate's degree, an active RN license, and at least 2 years of clinical experience. Bountiful benefits, including PTO, medical plans, and 401(k), are offered to support your career growth. #J-18808-Ljbffr Texas Health Institute
- ...University of Minnesota School of Nursing is seeking a Clinical Claim Review Nurse who will perform claim reviews to verify coding and charges. You will work independently and... ...must hold an associate's degree and an active RN license, with a minimum of 2 years of clinical...Remote jobClaims
- Stryker Corporation is seeking a Clinical Claim Review Nurse to perform detailed reviews of claims against medical records. The position offers... ...Candidates should possess an Associate's degree and an active RN license. Responsibilities include ensuring compliance with guidelines...Remote jobClaims
- Optum is seeking a Clinical Claim Review Nurse to perform claim reviews and ensure compliance in a telecommute role. You will verify coding accuracy and support health outcomes by connecting people... ...an Associate's degree, active RN license, and clinical experience. You...Remote jobClaimsFlexible hours
- Optum is looking for a Clinical Claim Review Nurse to perform claim reviews and ensure compliance with... ...state and federal policies. This fully remote position allows you to contribute to... ...possess an Associate's degree, an active RN license, and at least 2 years of...Remote jobClaims
$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records... ..., analyzes claims data, applies... ...Become subject matter expert for assigned... ...ICD-9/ICD-10/MS-DRG coding may be necessary.*... ...independently in remote setting with minimum... ...Active unrestricted RN license #J-18808-...Remote workClaimsFlexible hours- Optum is hiring a Clinical DRG RN auditor to verify DRG coding accuracy and reimbursements while telecommuting from anywhere in the U.S. In this role, you... ...use your ICD-10 coding expertise to audit inpatient claims, identify overpayments, and support your findings with...Remote jobClaims
- ...for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing... ...documenting decisions based on established clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical...Remote workClaimsFull time
$28.94 - $51.83 per hour
.... Growing together. The Clinical Review Clinician serves as a subject matter expert for itemized bill reviews... ...understanding of the claim review process including... ...Active and unrestricted RN license OR LPN in the state... ...Auditing and coding certifications Experience...Remote workClaimsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$70k - $80k
...analytics and solutions company is seeking a Clinical Validation Auditor to ensure accuracy in medical claims coding. This fully remote position requires a Registered Nurse with... ...care experience. Responsibilities include reviewing medical records, documenting findings, and...Remote jobClaims- ...company located in New York is looking for a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring compliance... ...guidelines. This role requires an active RN license and the ability to analyze claims data and regulations effectively. The...Remote jobClaims
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Review Clinician to perform Forensic Reviews on hospital bills, assisting with claims resolution and departmental goals. The role requires strong clinical knowledge and the ability to analyze charge details comprehensively. Benefits...ClaimsHourly pay$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant... ...performs medical claims audit reviews. As... .... You will work remotely in a fast paced... ...; assist with QA functions and... ..., CPT-4 or HCPCS coding. Knowledge of insurance... ...unrestricted RN license in good standing...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work- ...hybrid, onsite or remote. While the majority... ...Customer Service, Claims Processors, and... ...activities. Provide clinical and operational analysis... ...Conduct clinical review of complaints... ...and subject matter experts. Practice... ...of CPT-4 and ICD coding Knowledge of URAC...Remote workClaimsFull timeWork experience placementWork at office1 day per week
- Stryker Corporation is looking for a Clinical Claims Review RN to perform reviews of inpatient hospital claims. This role supports a high-volume environment and allows for telecommuting from anywhere in the U.S. The ideal candidate must have an RN license, a minimum of...Remote jobClaims
- ...for the Future is seeking a DRG Appeals Review Nurse to analyze and appeal denied MS-... ...have a Registered Nurse License, relevant coding certifications, and extensive clinical experience. Key responsibilities include reviewing claims for appeal potential, writing detailed...Remote workClaimsWork from home
- Optum, part of the UnitedHealth Group, is looking for a Clinical Claims Review RN to conduct administrative reviews of short stay inpatient hospital claims. This position is open to telecommuting from anywhere in the U.S. and is situated in a high-volume, production-driven...Remote jobClaims
$28.94 - $51.83 per hour
Crains Cleveland is seeking a Clinical Claims Review RN to perform administrative reviews of short-stay inpatient hospital claims. This role supports a production-driven environment and allows telecommuting from anywhere in the U.S. The ideal candidate must have an associate...Remote jobClaimsHourly pay$29.05 - $67.97 per hour
...clinician for a role focused on medical claims review in Albuquerque, New Mexico. The... ...demands at least 2 years of clinical nursing experience and an active RN license. Responsibilities include... ...skills, along with a deep understanding of coding practices. #J-18808-Ljbffr...ClaimsHourly pay- UnitedHealth Group is seeking a Clinical DRG RN auditor to leverage expert coding knowledge in auditing inpatient claims. This remote role allows for flexibility within the U.S., focusing... ...overpayments. Responsibilities include reviewing code assignments, providing rationale...Remote jobClaims
- ...Healthcare in Louisville, KY, is seeking a Clinical Reviewer to utilize clinical knowledge for validating medical claims and ensuring compliance with state... ...the accuracy of billing and coding. Ideal candidates should possess a valid RN license, at least 2 years of nursing...Claims
$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... ...compliance with regulations. The ideal candidate will have an RN license in California and a minimum of three years of...Remote jobClaimsHourly pay- Stryker Corporation is seeking a Clinical Review Clinician to serve as a subject matter expert for itemized bill reviews. This role involves analyzing hospital bills, conducting forensic reviews, and maintaining compliance with HIPAA standards while working independently...Remote jobHourly pay
$29.05 - $67.97 per hour
Molina Healthcare is seeking a Clinical Nurse Reviewer in Albany, NY, responsible for reviewing medical documentation... ...medical reviews of appeals and validating claims for coding compliance. Candidates must hold an active RN license and have at least 2 years of clinical...Remote jobClaimsHourly pay$29.05 - $67.97 per hour
...Molina Healthcare is seeking a clinical nurse responsible for reviewing documentation for medical... ...appeals facilitation, claims auditing, and ensuring accurate billing under coding regulations. The ideal candidate... ..., and must hold an active RN license. Key skills include...ClaimsHourly pay$29.05 - $67.97 per hour
..., is seeking an experienced clinical professional responsible for conducting medical reviews and validating claims to ensure appropriate reimbursement... ...nursing and an active RN license. Candidates should... ...knowledge of ICD-10 and CPT coding, alongside strong analytic and...ClaimsHourly pay$29.05 - $67.97 per hour
...Antonio, Texas, to join their team for clinical review responsibilities involving medical necessity and claims processing. This role requires at... .... Candidates must hold an active RN license and demonstrate proficiency in billing and coding standards. The position offers a...Remote jobClaimsHourly pay- ...oriented Registered Nurse Clinical Auditor to support medical record reviews and billing compliance... ...Programs. This remote role requires evaluating... ...should preferably hold an RN license, coding certification, and have... ...experience in Medicaid claims review. Strong analytical...Remote jobClaims
$29.05 - $67.97 per hour
..., Arizona is seeking a clinical nurse to oversee the medical review process, ensuring claims and records meet necessary... ...-making based on expert judgment. Applicants must possess an active RN license and have experience... ..., familiarity with coding and regulatory standards...ClaimsHourly pay- Molina Healthcare is seeking a clinical professional in Miami to perform utilization reviews and ensure proper coding for reimbursement. This role... ...will evaluate medical claims and facilitate appeals, contributing... ...compliance. An active RN license is essential, along...Remote jobClaims
- ...detail-oriented Registered Nurse Clinical Auditor to support medical record reviews and billing compliance... ...ideal candidate should have an RN license, coding certification, and at least 1 year of Medicaid claims review experience. This remote position requires occasional...Remote jobClaims
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