Remote Appeals RN — Payment Integrity & Claims Review
$80k - $90kJimmy Jazz
- Remote job
6 Degrees Health is hiring a Payment Integrity Appeals RN to join their team. This remote position involves reviewing provider appeals related to claim determinations and ensuring compliance with regulations. The ideal candidate will have experience in claims review and appeals, along with a Bachelor of Science Degree in Nursing and an unencumbered RN license. The role offers a competitive salary ranging from $80,000 to $90,000, alongside benefits such as unlimited paid time off, a 401(k) program with employer matching, and various health coverage options. #J-18808-Ljbffr Jimmy Jazz
$80k - $90k
...expertise across the payment continuum,... ...0-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...research, analyzes claims data, applies knowledge... ...work independently in remote setting with minimum... ...Confidentiality and Integrity of Sensitive, Proprietary...Remote workClaimsFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- ...solutions firm seeks a Payment Integrity Supervisor to oversee daily... ...and resolving provider appeals. The ideal candidate... ...service delivery. This remote position requires strong experience in claims processing and... ...Degree in Nursing and RN licensure. #J-18808-Ljbffr...Remote jobClaimsDaily paid
- ...hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals and validating claims to ensure medical necessity and... ...utilization review, and a valid RN license in Florida or Kentucky....Remote jobClaimsFull time
$24.2 - $36.3 per hour
...preventing inaccurate payments and reducing overall waste... ...-Payment Accuracy and Integrity and is HI-TRUST and SOC... ...and recover improper claim payments. This role performs... ...and verification Review, prioritize, and... ...inquiries, disputes, and appeals related to determinations...Remote workClaimsFull timeContract workVisa sponsorship$86k - $105k
...Pre-Payment Review Nurse Consultant- Wisconsin It takes great medical... ...of the Clinical Program Integrity & Compliance Section, this highly... ...and financial records, claims, and claims data to obtain documentation... ...of Wisconsin. Role is 100% remote. No travel obligations....Remote workClaimsFull timeWork at officeFlexible hours- ...nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be... ...will be responsible for reviewing medical correspondences,... ...providers warrants a change in claim payment. This is a non-... ...a Payment Integrity or Appeals unit. Familiarity with...Remote workClaimsContract work
- ...Payment Integrity Product Development Specialist (Skilled Nursing Facility... .... Define and validate claim selection logic, risk... ...intake, clinical review, provider outreach and appeals. Define SLA expectations... ...Preferred Experience RN, PT, OT, SLP or other clinical...Remote workClaims
$69.4k - $99.2k
...Senior Data Mining & Payment Integrity Analyst Be part of a team that... ...improper payments and improve claims accuracy across dental, medical... ...to providers through data review and analytics across dental,... ...applied. Support the appeals, validation, and client services...Remote workClaimsFull timeContract workFlexible hours$66.94k - $101.26k
...Description The Payment Integrity Analyst is responsible... ...for accurately reviewing and completing pre- and post pay claim audits based on client... ...audits and/or appeals in accordance with... ...current LPN, LVN and/or RN licensure... ...regulations as applicable. #LI-Remote...Remote workClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours$29.05 - $67.97 per hour
...experience, responsible for review of documentation to... ...medical record and claim submitted support correct... ...concurrent review of appeals for denied prior... ...opportunities identified by the payment integrity analytical team; makes... .... Registered Nurse (RN). License must be...ClaimsHourly payWork experience placementWork at office$77.96k - $120.37k
...The Payment Integrity Supervisor is responsible for the daily... ...assurance and provider appeals. The Supervisor manages... .... This is a remote position. ESSENTIAL... ...by CERIS Ability to review and apply clinical... ...Strong understanding of claims processing, ICD-10 Coding...Remote workClaimsDaily paidMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours- ...Clinical Appeals Reviewer (Licensed Healthcare Professional) Fully Remote-United States Job Type... ...Registered Nurses (RN), Physical... ...including coverage and payment rules.... ...Medicare regulations, claims processing, and the... ...customers. Show integrity and ethical behavior...Remote workClaimsFull timeContract workPart timeFor contractorsWork at officeLocal areaNight shift
$51.06 - $73.9 per hour
...Senior Manager Payment Integrity SCAN began with a simple but radical... ...Billing, Authorizations, Claims, Encounters, Member... ...issues and coordination of appeals with the Audit and Review team. Supports other Business... .... Work Mode: Mostly Remote. Medical Benefits....Remote workClaimsHourly payTemporary workWork at office$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that... ...completes required CEUs to maintain RN license and/or coding certification.... ...trains to perform reviews of multiple claim types to provide a flexible workforce...Remote workClaimsFull timeWork from homeRelocation packageFlexible hours$41 - $43 per hour
...looking for a Medical Claims Review Nurse to work with our... ...Client! Location: Remote (Candidates must reside... ...candidates must have a valid RN License and have... ...for administering claims payments, maintaining claim records... ...cases, in which an appeal has been submitted, to...Remote workClaimsHourly payWork at officeLocal area- Overview Job Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06 Months/Can be Extended Working hours:... ..., and reporting platforms Licensure/Certification Valid RN, LPN, or LVN license in applicable state (Florida) Skills...Remote workClaimsContract workDay shift
- ...Registered Nurse: Review and Evaluation Are... ...and program integrity through compliance... ...to review and audit claims, support program integrity... ...Registered Nurse (RN) license Strong... ...vulnerable populations Remote work – enjoy the... ...reason codes, and appeal rights in...Remote workClaimsFull timeTemporary workWork at officeWork from home
$64.83k - $85.09k
Senior Analyst, Payment Integrity Disputes Remote Hi, we're Oscar. We're hiring a Senior... ...resolution in the Oscar claim environment for both the Oscar... ...research and claims review to ideate payment integrity... ...focused on Disputes and/or appeals 4+ years of experience in...Remote workClaimsFull timeContract workWork at office- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple... ...validity of health claims and levels of payment in meeting national... ...consent, etc.) or appeal. This may involve... ...Registered Nurse (RN) license PREFERRED... ...serving both with integrity and a shared desire...Remote workClaimsPermanent employmentWork at officeLocal area
$90k - $99k
...talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate... ...required CEUs to maintain RN license and/or coding... ...perform reviews of multiple claim types to provide a flexible workforce... ...should expect in this role Remote (Work from Home) Up to 25% Travel...Remote workClaimsFull timeWork from homeRelocation packageFlexible hours- ...advocacy and program integrity through compliance management... ...bedside setting to review and audit claims, supportprogram... ...unrestricted Registered Nurse (RN) license Strong... ...populations Remote work - enjoy the... ...letters, reason codes, and appeal rights in accordance...Remote workClaimsFull timeTemporary workWork at office
$75 - $78 per hour
...their capacity to seamlessly integrate cutting-edge digital and design... ...: Senior Product Manager – Payment Integrity Role Overview... ...incorrect payments, improve claims accuracy, optimize reimbursement... ...iteration planning, sprint reviews, and release cycles with engineering...Remote workClaimsTemporary work$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence... ...management programs integrate Strong... ...applications This is a 100% remote role, and requires... ...prior authorization, payment accuracy, and more–the... ...with post-service claims validation, we're creating...Remote workClaimsFull timeFlexible hoursShift work$78.5k - $90k
...expertise across the payment continuum,... ...The Medical Review Nurse - Home Health... ...medical claims audit reviews on... ...You will work remotely in a fast paced... ...findings during the appeals process if... ...Active unrestricted RN license in good... ...and Integrity of Sensitive, Proprietary...Remote workClaimsFor contractorsWork at officeWork from homeHome officeShift work$182k - $217k
...looking for a Director, Payment Integrity based in United States... ...across complex claims and reimbursement processes... ...highly collaborative, remote-first environment where... ...Registered Nurse (RN) license and/or Certified... ...ensure your application is reviewed quickly, objectively,...Remote jobClaimsFull timeContract work$113.77k - $215.57k
...Auditor Principal - Carelon Payment Integrity Location: Alternate... ...in a hybrid model (remote and office). The ideal... ...inpatient medical records on claims paid based on... ...clients. Specializes in review of DRG coding via medical... ...that disputes or appeals may only be reviewed by...Remote workClaimsDaily paidWork at officeLocal area1 day per week- ...Appeals Analyst We are currently hiring for an Appeals... ...appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Additionally... ...An active, unrestricted RN license from the United... .... Knowledge of claims systems. Ability to effectively...Remote workClaimsFull timeFor contractorsCurrently hiringWork at officeLocal areaMonday to Friday
$45.29 - $84.11 per hour
...better. Hybrid/Remote Summary: The purpose... ...part in preventing payment denials by... ...obstacles and deny claims and escalating any... ...Responsibilities: # Review all inpatient admission... ...and trending all appeals and communicating... ...Required: Current RN License in Connecticut...Remote workClaimsHourly payDaily paidPart timeShift workNight shiftRotating shift- Integrity Management Services, Inc. is seeking an experienced Clinical... ...Nurse Auditor to join their Payment Integrity team in Alexandria... ...fraud via comprehensive reviews of claims and provider records. This position... ...a Registered Nurse (RN) with coding certifications...Claims
$95.1k - $135.8k
...Payment Integration Product Solution Architect Be part of a team that unleashes... ..., Clinical Medical Record Review, COB, and Bill Audit ~8+... ...in healthcare, preferably a claim payment or audit recovery... ...expect in this role: Fully remote opportunity with the option...Remote workClaimsFull timeFlexible hours
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