Remote Appeals RN - NY Licensed Case Review Expert
Medix
Medix™ is seeking a dedicated Appeals Nurse (RN) to join our team in a fully remote capacity. This role involves clinical reviews and appeal determinations while collaborating with Medical Review Analysts and Physician Consultants to ensure compliant outcomes. The ideal candidate must have a current New York State RN license and a Bachelor's Degree in Nursing. Enjoy the flexibility of remote work while contributing to fair healthcare appeal determinations. #J-18808-Ljbffr
- ...Health Solutions is looking for an Appeals Nurse responsible for examining... ...claims for first-level appeal cases. The role involves reviewing denied services and working... ...a nursing degree and an active RN license. The position offers remote work options along with a comprehensive...Remote work
$29.05 - $67.97 per hour
...experience, responsible for review of documentation to ensure medical... ...is not included in a compact RN license. Job Duties Facilitates... ...retrospective, and concurrent review of appeals for denied prior... ...Includes standard and expedited cases, inpatient, outpatient, and...Remote jobHourly payWork experience placementWork at office$66k - $68k
...WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeal cases. In this role, you will collaborate with examiners to... ...clinical healthcare settings and an active RN license are essential for this position. The Appeals...Remote work- ...Health Solutions) is seeking a full-time remote Licensed Appeals Nurse. This role involves examining... ...records and claims for first-level appeal cases, ensuring compliance with Medicare... ...guidelines. The ideal candidate should have an RN license, along with relevant nursing...Remote workFull time
- ...Downtown Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform all... ...analyzing provider appeals and preparing case summaries for hearings. This position is a full-time, permanent remote role that complies with work-from-home...Remote workPermanent employmentFull timeWork from homeFlexible hours
- ...Solutions is seeking an Appeals Nurse in Michigan to... ...and claims for appeal cases. This role involves collaboration... ...and entails thorough reviews to ensure regulatory... ...degree and an active RN license, along with at least one... ...opportunity offers remote work options and various...Remote work
- ...Barbara Cottage Hospital is seeking a Case Manager - Utilization Review Specialist to work remotely. This role involves analyzing patient... ...compliance with regulations, and managing appeals. Candidates should possess a current RN license and significant healthcare experience,...Remote work
$24 - $56.17 per hour
...Provides support for clinical member services review assessment processes. Job Summary... ...required timelines. Refers appropriate cases to medical directors (MDs) and presents... ...business operating model, or state board licensing mandates. If licensed, license must be active...Remote jobHourly payFull timeContract workWork experience placementWork at office- ...NeuroPsychiatric Hospitals is seeking a Utilization Review Nurse (RN) to coordinate patient services across multiple hospitals. The role supports... ...and collaborating with teams for better outcomes. Located remotely with a preference for candidates in Indiana, Michigan, or...Remote work
- ...Elevance Health seeks a Nurse Appeals - Licensed Nurse to investigate medical necessity appeals... ...successful candidate must hold an active RN license and have a minimum of 2 years of... ...care. Key responsibilities include reviewing medical records, preparing recommendations...Remote workFull time
$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work$50 per hour
...Drips.com is looking for an Appeals RN (Temporary) to handle grievances... ...in nursing and a current RN license, along with at least two... ...management. The position is remote and offers a salary of $50/hr... ...you will be responsible for reviewing and processing appeals, performing...Remote workTemporary work- ...Solutions in Omaha is seeking an Appeals Nurse to examine medical... ...appeals. This role involves reviewing the medical necessity of services... ...ideal candidate will have an RN license, clinical experience, and... ...skills. The position offers remote work options and benefits including...Remote work
- ...Elevance Health is seeking a Nurse Appeals - Licensed Nurse to investigate and process medical necessity... ...candidates must have an active RN license and at least 2 years of experience... ...healthcare setting. The selected candidate will review medical records and document grievances...Remote workFull time
- ...Health Solutions is seeking an Appeals Nurse to examine medical records and claims for appeal cases under Medicare regulations. This... ...Candidates must hold an active RN license and have clinical experience. The position offers remote work capabilities and competitive...Remote work
- ...Elevance Health is seeking a Nurse Appeals - Licensed Nurse to investigate medical necessity appeals... ...ideal candidate must hold an active RN license and have experience in a managed... ...care setting. Responsibilities include reviewing denied services, documenting appeals,...Remote workFull time
- ...Health Solutions is seeking an Appeals Nurse to examine medical records for first-level appeal cases, ensuring services meet... ...guidelines. With options for remote work, the ideal candidate will... ...have a nursing degree and active RN license, accompanied by comprehensive...Remote work
- ...Management Nurse. This role focuses on performing utilization reviews, evaluating patient records, and ensuring compliance with state... ...care setting. This position provides a hybrid work environment that combines both remote work and office settings. #J-18808-Ljbffr...Remote workWork at office
- ...solutions company is seeking an Appeals Nurse to review medical records and claims for appeal cases. You will collaborate with the... ...nursing degree and an active RN license with experience in a... ...offers a salary range of 66-68k, remote work options, and comprehensive...Remote work
- ...WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeal cases. This role collaborates with... ...candidate has a nursing degree, an active RN license, and strong communication skills. Remote work options are available, and...Remote work
- ...WPS Health Solutions is seeking an Appeals Nurse to examine medical records for appeal cases regarding Medicare coverage. This remote position requires strong clinical expertise... ...must hold a nursing degree and an active RN license, along with one or more years of clinical...Remote work
- ...company is seeking an Appeals Nurse to examine medical... ...for first-level appeal cases. The RN works closely with Appeals... ...timely and medically reviewed redeterminations. The... ...nursing degree and active RN license, plus strong communication skills. Remote work options are...Remote work
- ...solutions company is seeking a Medical Review Nurse Analyst to review medical... ...TRICARE compliance, requiring a BSN and RN license. The analyst will analyze medical... ...teams, and manage high-risk cases. The role allows for remote work in several states and comes with...Remote work
- ...content quality team as an Expert Question Reviewer for NCLEX-RN exam preparation materials... ...position — flexible, remote, and project-based. You'll... ...drag-and-drop, unfolding case studies) are structurally... ...Qualifications Active RN license (BSN minimum) 5+ yrs clinical...Remote workContract workFlexible hours
- ...contract role primarily focused on reviewing clinical data and managing member appeal requests in accordance with... ...policies. The position allows for remote work, preferably from Iowa, with possible... ...include preparing case reviews, generating appeal communications...Remote workContract work
- ...Huntsville Memorial Hospital is seeking a Utilization Review Nurse to provide clinical reviews of cases for medical necessity. In this role, you'll... ...focus on quality assurance. This position requires an RN license in Texas and a minimum of 2 years of experience in Acute...
- ...a Clinical Auditor to perform clinical reviews and audits on medical records, ensuring... ...guidelines. This role requires an active RN license and the ability to analyze claims data and... ...documentation and reporting within the appeals process, contributing to continuous improvement...Remote work
$33.65 - $38.46 per hour
...Role The Registered Nurse Case Manager is a key member ofAptiHealth... ...need Conduct medical reviews and gatheradditionalpatient... ...Active Registered Nurse (RN) license in New Yorkrequired Graduate... ...Friday 8am - 4:30pm Location: Remote / NY Pay Rate: $33.65- $38.46/...Remote workHourly payFull timeWork at officeWork from homeMonday to Friday$87k - $101k
...Job Description RN Case Manager – Los Angeles, CA Region Work from home + local field travel... ...Bonus Opportunities Free CEUs for licenses & certificates License & Certification Reimbursement... ...in the community! Responsibilities Reviews case records and reports, collects and...Remote workWork at officeLocal area$80k - $90k
...0-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for... ...as a subject matter expert, providing supplemental... ...tools, and case management system/tools... ...work independently in remote setting with minimum... ...Active unrestricted RN license in good standing and...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work
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