Senior Medical Review Nurse - Remote Claims & Compliance
$34 per hourkozmetickesluzby.vecnakraska.sk - Jobboard
The kozmetickesluzby.vecnakraska.sk - Jobboard is seeking a Sr. Medical Review Nurse for a remote position based in Baltimore, MD. This role involves comprehensive reviewing of medical records, coding practices, and working with stakeholders to ensure compliance and accuracy.
The ideal candidate will hold an active RN license with 3-5 years of experience in medical review and possess strong analytical and communication skills. This is a full-time position offering a competitive salary of $34.00 per hour.
#J-18808-Ljbffr- ...healthcare platform, the full-time Medical Review Nurse will ensure compliance with CMS regulations for durable medical... ...data security while working remotely. Key Responsibilities Review DMEPOS... ...utilization management reviews, or claim audits Proficiency with medical review...Remote workMedicalClaimsFull timeFlexible hours
$78k - $99.2k
...partner is looking for a Senior Nurse Reviewer based in the United... ...quality and claims accuracy by applying... ...expertise to complex medical reviews. As a Senior... ...charges, and support compliance with applicable policies... ..., and feedback. This remote opportunity combines...Remote workSeniorMedicalClaimsFull timeWork from homeFlexible hours- Commence is seeking a Nurse Reviewer to perform complex medical record reviews of Medicare Part A/B and DMEPOS claims. The role requires clinical judgment... .... The position is remote, offering flexibility while... ...documentation skills and HIPAA compliance. #J-18808-Ljbffr Commence...Remote jobMedicalClaims
$64.5k - $92.2k
Gainwell Technologies LLC is seeking a Clinical Quality Nurse Reviewer, Sr. Specialist for a remote role. You will conduct quality assurance audits of clinical staff's work and ensure compliance with medical records and guidelines. The position requires an active RN license...Remote workSeniorMedical$78k - $99.2k
...It takes great medical minds to create powerful solutions that... ...a talented individual for a Senior Nurse Reviewer to perform reviews of medical records, healthcare claims, itemized medical bill, and... ...4 forms to ensure accuracy, compliance, and proper billing practices...Remote workSeniorMedicalClaimsFull timeWork from homeFlexible hours- ...The utilization review and management (UM... ...contracted facilities are medically necessary,... ...supporting regulatory compliance and organizational... ...documentation of claims along the process... ...Qualifications ~ Registered nurse with active,... ...an in-office, no remote work capability...Remote workMedicalClaimsWork at office
$40 per hour
PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role... ...reviews for Medicaid claims. This involves meticulous... ...medical records to ensure compliance with established guidelines...Remote workMedicalClaimsContract workWork at officeLocal areaImmediate start- ...Management Department (Fully Remote) Provides health care... ...planning and utilization review. Reviews admissions and... ...concurrent and retrospective medical necessity and/or compliance with reimbursement policy... ..., reimbursement and claim denials/appeals. Assesses...Remote workMedicalClaims
$29 - $52 per hour
...Program Integrity Clinical Compliance Auditor Optum... ...performing compliance reviews of medical and administrative documentation... ...providers who submit claims for payment. This... .... This position is Remote in Massachusetts. You... ...work experience ~ Nurse licensure (RN or LPN)...Remote jobMedicalClaimsHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work- Utilization Review Nurse Auditor (33034)# Utilization Review... ...Auditor (33034)Fully Remote • Mount Laurel, NJ 080... ...care that is medically necessary and appropriate... ...that all work is in full compliance with client contractual... ...law firms, third-party claim administrators and...Remote workMedicalClaimsLocal areaMonday to Friday
- ...Registered Nurse: Review and EvaluationAre you a registered nurse ready... ...program integrity through compliance management. Here, you'll champion... ...setting to review and audit claims, support program integrity... ...nursing judgment to analyze medical records, documentation, and...Remote workMedicalClaimsWork from home
- ...with attorneys, clients, claims professionals, and... ...Professional Liability, Medical/Dental Malpractice, Premises... ...Request, organize, and review medical records,... ...billing, timekeeping, and compliance with client-specific billing... ...effectively in a fully remote environment. ~ Highly...Remote workSeniorMedicalClaimsWork at office
- ...retrospective clinical reviews across multiple lines... ...of business, assessing medical necessity, coding... ...discharge planning, and compliance requirements while supporting... ...clinical reviews of claims for medical necessity,... ...~ Associate Degree in Nursing required ~ Bachelor...SeniorMedicalClaimsFull timeContract workPart timeWork at officeLocal areaWork from homeHome officeWeekend workAfternoon shift2 days per week
- ...Claims Review Management Nurse (RN) We are seeking an experienced Claims... ...(three days remote, two days onsite). This... ...familiarity with Medicare and Medical Assistance... ...will collaborate with senior leadership to... ...program effectiveness and compliance. This role requires...Remote workMedicalClaimsLong term contractFull timeContract workWork at office2 days per week
$138k - $210k
...executionCo-lead the monthly close review, quarterly forecast cycle,... ...offer Gongsters a variety of medical, dental, and vision plans,... ...stipend to help you succeed in a remote environment.The annual salary... ...gong.io domain. Any outreach claiming to be from Gong via other...Remote workSeniorMedicalClaimsImmediate startWork from homeFlexible hours- ...Quality Assurance / Compliance Registered Nurse (QI/QA/Compliance RN)... ...Requirements, Federal Tort Claims Act (FTCA) standards,... ...rural, frontier, and remote healthcare... ...care, patient‑centered medical home (PCMH), and care... ...Participate in peer review and clinical case review...Remote workMedicalClaimsWork at office
$112.7k - $193.2k
...Utilization Management and Medical Necessity. InterQual... ...and InterQual Medical Review Service are Optum's flagship... ...workflows.This Senior Product Manager owns product... ...flexibility to work remotely * from anywhere within... ...prior authorization, or claims systems, including clinical...Remote workSeniorMedicalClaimsMinimum wageFull timeWork experience placementWork at officeLocal area- ...sciences, is seeking a " Senior Program Director,... ..., CA (Fully Remote) Duration: Long-Term... ...Company Benefits: Medical, Dental, Vision,... ...lead Promotional Review Committees (PRCs),... ...Affairs, Legal, and Compliance to ensure FDA-... ...advertising and promotional claims Partner with...Remote jobSeniorMedicalClaimsLong term contract
- ...sciences disputes, compliance, and... ...Role Overview:The Senior Managing Director... ...engagements.Direct and review the development of... ...collection and analysis, medical record review, the... ...coding and billing of claims, quality control... ...future.#LI-NT1#LI-Remote*Ankura is an Affirmative...Remote workSeniorMedicalClaimsFull time
- ...unified Epic electronic medical record across the... ...Billing Office, Claims, Contracts, and... ...varying complexity by reviewing release... ...*Requirements for Senior Level:Bachelor's degree... ...hybrid or mobile/remote work mode are at the... ...are performed in compliance with the Fair Credit...Remote workSeniorMedicalClaimsWork at office
$108k - $156k
...applicants for a Senior Equipment Breakdown... ...will also perform claims investigations which... ..., invoice review, and cause of loss... ...exposure.This is a remote-based role that requires... ...opportunity and compliance with all laws and... ...physical disability, medical condition, genetic...Remote workSeniorMedicalClaimsLocal area$120k - $180k
...Job Description: The Senior Actuary, Reserving performs... ...Actuary partners with Claims, Finance, Underwriting,... ..., and assumption reviews to evaluate reserve adequacy... ...disability insurance ~ Medical, dental and vision... ...work schedules and hybrid/remote options for eligible positions...Remote workSeniorMedicalClaimsTemporary workWork at officeHome officeFlexible hours- ...Description Senior Director, Financial... ...management of EHP's medical, pharmacy, and... ...controls, and regulatory compliance frameworks that... ...financial review and interpretation... ...reserve management, claims lag analysis, and... ...the right to change remote work status with notice...Remote workSeniorMedicalClaimsContract workWork from homeFlexible hours
$75k - $90k
...Healthcare Financial/Actuarial Senior AnalystAs a Healthcare... ...programs including medical, dental, life,... ...Contributes to vendor financial reviews for clients.Provides... ...accurate and reliable claim reporting and financial... ..." style, with a mix of remote, in-person and in-office...Remote workSeniorMedicalClaimsTemporary workWork at officeLocal areaFlexible hours- ...Are you a registered nurse ready to take your career... ...integrity through compliance management. Here, you... ...bedside setting to review and audit claims, supportprogram integrity... ...judgment to analyze medical records,... ...vulnerable populations Remote work - enjoy the convenience...Remote workMedicalClaimsFull timeTemporary workWork at officeWork from home
$35 per hour
...range $35.00/hr - $35.00/hr Medical Review Nurse Location: Phoenix, AZ 85034 (Remote) 3+ Months Day Shift... ...Federal Emergency Services (FES) 1500 claim forms. Some coordination will be... ...once starting position. Seniority level ~ Seniority level Mid...Remote workMedicalClaimsHourly payContract workTemporary workPart timeFor contractorsWork at officeShift workDay shift$92k - $138k
...immediate opening for a Senior Regulatory Affairs... ...This role will be remote. Under limited... ...and overall compliance.Communicate requirements... ...and scenarios.Review and provide direction... ...labeling and claims.Manage individual... ...etc.), engineering, medical technology, regulatory...Remote workSeniorMedicalClaimsMinimum wageFull timeLocal areaImmediate startWorldwide$75k - $100k
...The Senior Paralegal serves as a trusted advisor to... ...corporate governance, compliance, licensing, contracts,... ...management, including the review of AI-related... ...enforcement. Oversee claims and litigation management... ...health benefits including medical, dental, and vision...Remote workSeniorMedicalClaimsContract workTemporary workWork from homeFlexible hours$100k - $125k
...paid holidays, FEHB medical, dental, vision, 401... ...is recruiting for a Senior Environmental Compliance Specialist who will... ...Grand Junction, CO; Remote work arrangements may... ...documentation. Review and evaluate proposed... ...from individuals claiming to represent ASRC Industrial...Remote workSeniorMedicalClaimsFull timeTemporary workLocal areaImmediate start- ...HumanaPosted: Humana Inc. is seeking a Senior Medical Coding Outpatient Auditor to... ...coding accuracy, and ensure compliance with outpatient coding and... ...role involves researching claims anomalies, applying CPT/... ...improve audit strategies. Remote work with occasional travel...Remote workSeniorMedicalClaims
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Medical Review Nurse - Remote Claims & Compliance. Be the first to apply!
- senior business development Baltimore, MD
- american senior communities Baltimore, MD
- senior devops engineer remote Baltimore, MD
- senior information technology project manager Baltimore, MD
- senior vmware engineer Baltimore, MD
- sr electrical engineer Baltimore, MD
- senior dynamics crm developer Baltimore, MD
- senior program analyst Baltimore, MD
- senior director Baltimore, MD
- senior financial analyst Baltimore, MD




