Remote Clinical Appeal Specialist RN, Coding & Payer
Partner Engineering and Science
- Remote job
Partner Company is a remote-focused organization dedicated to improving patient outcomes within cancer care. This role supports revenue cycle optimization by evaluating denied claims and developing appeal strategies. The candidate brings an active RN license, reimbursement knowledge, and experience with medical coding and payer policies, along with strong Excel, analytical, and communication skills, to drive improvements across the revenue cycle in a fully remote setup. #J-18808-Ljbffr Partner Engineering and Science
$66.54k - $101.5k
...partner is looking for a Clinical Appeal Specialist based in the United... ...healthcare regulations and payer requirements. Working... ..., medical coding, and insurance policies... ...to detail in a fully remote-eligible position.... ...active Registered Nurse (RN) license. Associate...Remote workHourly payDaily paidFull timeWork at office- ...policies and procedures; The Clinical Appeals Specialist is responsible for the... ...to disclose assigned user ID code and password for accessing resident... ...works independently in a remote settingQuality - Demonstrates... ...knowledge of regulatory and payer reimbursement requirements...Remote work
- ...About the Job: The Nurse Appeals Specialist is responsible for... ...thorough evaluation of clinical documentation to support... ...and prevention of payer denials. This position... ...accuracy, medical necessity, coding, and other key... ...License : Applicable RN license. Certified coding...SuggestedPermanent employmentWork at officeShift work
- SolutionHealth in Manchester, NH seeks a Nurse Appeals Specialist to evaluate clinical documentation and support the denial... ...appeal letters, and presenting to payers under policy guidelines. A strong nursing background with coding/auditing experience is required. #J-18...Suggested
- ...Priority Management is seeking a Clinical Appeals Specialist to perform comprehensive clinical reviews... ...The role requires proficiency in MDS coding, HIPAA compliance, and regulatory documentation... ...EHRs, and coordinate with teams in a remote, production-oriented environment to...Remote work
$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 - 100% Remote role at Healthfirst . Position Summary: The Appeals & Grievances (A&G) unit...Remote jobFull timeMonday to FridayShift work$52k - $270.4k
Clinical & Health Specialist Remote Role Role/Domain | Exp | Geo Utilization... ...Authorization, and Payer Claims ● Dietetics... ...Policy ● Medical Coding, CDI, Billing, and... ...Active PT, OT, SLP, RN, RD/RDN, LCSW,... ...authorization, payer appeals, medical coding, CDI...Remote workFull timePart timeFor contractors$108.51k - $196.41k
...Description Summary The Appeals team oversees all operational and clinical aspects of the appeals... .... The Appeal Clinical Specialist is responsible for... ...company location (or from a remote location with management... ...high-value solutions to payers, providers and consumers...Remote workFull timeWork at officeLocal areaMonday to FridayNight shiftWeekend work$40 - $46 per hour
...A client of Innova Solutions is immediately hiring for a RN Clinical Appeals Specialist Position type: Full time Contract to hire Duration: 3-month contract Location: Philadelphia PA 19103 (Remote) As a RN Clinical Appeals Specialist you will: Manage...Remote workHourly payFull timeContract workTemporary workFor contractorsWork experience placementWork at officeImmediate startWorldwideFlexible hours- ...firstsourc is seeking a Clinical Denials Specialist for a remote role in the United States. You... ...necessity, and prepare timely appeals. The position emphasizes accurate... ...and compliance with payer policies. The candidate should have an RN background or related clinical...Remote work
$66.54k - $101.5k
...the denials review and appeals management processes... ...experience and RN required (OR) ~"in lieu... ...currently in the role of Clinical Denial Specialist will be given a... ...and charging and coding guidelines. Intermediate... ...benefit investigations, payer reimbursement policies...Daily paidFull time- Investigate denied claims and appeal strategies. Analyze payer policies and trends.... ...Requirements: Active RN license and... ...reimbursement knowledge. Medical coding and payer policy... ...skills. Fully remote-eligible. Partner Company... ...remote team blending clinical, financial, and...Remote job
- ...UChicago Medicine , as a RN Manager for the Revenue... .... The Manager, Clinical Revenue Integrity & Appeals is responsible for providing... ...management, patient access, coding, revenue cycle, and payer organizations to... ...Work Location: Flexible Remote (Will need to commit to...Remote workFull timeMonday to FridayFlexible hoursShift work
- ...Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department: Clinical Appeals Reports To: Director of Clinical... ...appeal strategies, and drafting payer-ready appeal documentation. This... ...of appeal Collaborate with coding, CDI, denial recovery, and operations...Remote work
$73.4k - $120.36k
Position Summary: The Appeals & Grievances (A&G)... ...of or delivery of clinical and non-clinical... ...The A&G Clinical Specialist is the subject... ...This is either a remote or on-site position... ...diagnosis, and CPT codes and descriptions)... ...Qualifications: ~ RN , LPN OR Dental...Remote workFull timeContract workTemporary workWork experience placementLocal area$36 - $40 per hour
...our own path. We’re a remote-first staffing and... ...fulfillment in your coding career. If you are an Appeals and Denials Nurse looking... ...Our requirements: RN or FMG: CDIP, CCDS,... ...according to payer guidelines. Keeps abreast... ...,000.00 1 month ago Clinical Review Nurse - Prior...Remote workPermanent employmentFull timeWork visa$95k - $110k
...a DRG Nurse Reviewer Appeals and Hearings to coordinate... ...using approved clinical and coding guidelines and documents... ...required CEUs to maintain RN license and/or coding... ...), Certified Coding Specialist (CCS), or Certified Professional... ...in this role Remote (Work from Home) Up...Remote workFull timeWork from homeRelocation packageFlexible hours$52 - $56 per hour
...Description Job Description Now hiring: Remote UM / Grievance & Appeals RN (NY License) | Contract | $52–56/hr... ..., a New York health plan, needs a clinical Grievance & Appeals nurse with a... ...New York RN license 2+ years of payer-side grievance & appeals experience,...Remote jobContract workImmediate start$38.2 - $57.3 per hour
...Responsibilities Utilize clinical nursing expertise... ...eligibility for appeal using established... ..., state, and payer-specific compliance... ...for authorization, coding, level of care, medical... ...the Clinical Appeal RN Lead, to present... ...Conditions Fully remote work environment...Remote workDaily paidFull timeTemporary workPart timeWork at officeLocal areaFlexible hoursShift work- ...Clinical Claim Editing Specialist UPMC Health Plan has an exciting... ...Operations Coding department. This... ...primarily work remotely, you'll come into... ...complex claims, appeals, provider inquiries... ...healthcare payer functions. Advanced... ...Nurse (RN) license in good...Remote workFull timeWork at officeLocal area
$52 - $56 per hour
...done UM. You've worked appeals. Now find a role that uses... ...'re hiring a contract RN for a New York health... ...and MLTC). You'll own clinical grievances and appeals... ...utilization management. 100% remote (U.S.) | Contract | $52... ...• 2+ years of payer-side grievance and appeals...Remote jobContract workAfternoon shift$40 - $50 per hour
...Job Description Job Description Clinical Appeals RN – 100% Remote $40-$50/hour | Part-Time & Full-Time Opportunities Available Our team partners... ...and outcomes. Stay informed about insurance policies, payer requirements, and applicable regulations to ensure...Remote jobPermanent employmentFull timeTemporary workPart time- ...New York health plan. You will own clinical grievances and appeals from intake to final decision letters... ...criteria. The position is 100% remote in the United States, with business... ...deadlines. Requires active NY RN license and payer-side experience. #J-18808-LjbffrRemote workContract workAfternoon shift
$54.1k - $116.76k
...is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you... ...and accurate resolution of clinical appeals by applying sound... ...expedited), MPO, Coding, or Behavioral Health appeals... ...active and unrestricted RN licensure in state of residence...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayShift work- ...role We're looking for an RN who has personally owned grievance and appeals cases from intake to... ...health plan. You'll handle clinical grievances, appeals and... ...and has moved into payer-side grievance and appeals... ...cases at once in a fully remote setting. Nice to haves...Remote job
- NTT DATA, Inc. is seeking a Clinical Reviewer Specialist to perform clinical and medical necessity reviews to support appeals processing. You will evaluate medical records and criteria... ...and state regulations. The role is fully remote within Florida, requiring 3 years of...Remote job
$119.14k - $184.95k
...Care Manager Appeals RN - REMOTE position. This position is Per Diem and will work 8- hour, Day... ...overall management and communication of clinically-based appeals between Providence... ...Services, California Region (PH&S) outside payers. Activities will be patient-focused, uniform...Remote workDaily paidMinimum wageShift workDay shift- Phaxis is hiring a Remote UM / Grievance & Appeals RN (NY License) for a contract role with a New York health plan. If you have owned appeals from intake... ...Fair Hearings and CMS external reviews. A NY RN license and payer-side experience are required. #J-18808-Ljbffr PhaxisRemote jobContract work
$109.9k - $243.9k
...artificial intelligence. The Clinical Informatics Specialist IV plays a critical role in... ...role allows for a blend of remote and on-site work, requiring... ...or Oracle platforms Coding experience in common languages... ...misconduct; or have filed an appeal of a finding of...Remote workHome officeFlexible hoursShift work- Centene Corporation is seeking an Appeals Liaison to act as the statewide contact for appeals, fair hearings, and external reviews. This remote role requires WA licensure and aligns with NCQA standards, with hours 8:00 am-5:00 pm PST, Monday-Friday. The role emphasizes...Remote jobMonday to Friday
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