Remote IBR Clinical Appeals Analyst (RN)
UnitedHealth Group
UnitedHealth Group seeks an IBR Clinical Appeals Analyst to analyze and respond to claim review appeals. This fully remote role requires expertise in auditing, coding, and clinical reviews. A minimum of 2 years of appeals experience and an unrestricted RN license are mandatory. The ideal candidate will perform complex analyses, collaborate with teams, and navigate web portals. The position offers a comprehensive benefits package including a 401k contribution and stock options. #J-18808-Ljbffr
- ...nurse to research the substance of complex appeal requests, perform clinical review to determine medical necessity,... ...required timeframes. This full-time remote role (40 hours/week, 8 a.m.-5 p.m. local time) requires an active RN license in the United States, CMS residency...Remote jobFull timeLocal area
$53.46k
...Researches the substance of complex appeal or retrospective review... ...appeal requests. Provides thorough clinical review or benefit analysis to... ...: This is a full-time, remote (40-hours/week) working an 8hr... ...: An active, unrestricted RN license from the United States...Remote workFull timeFor contractorsWork experience placementLocal areaMonday to FridayShift work- Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South Carolina... ...appeal requests, provide thorough clinical review or benefit analysis to determine... ...0am-5:00pm EST and will be fully remote in South Carolina or Georgia. What...Remote workFull timeFor contractorsWork experience placementCurrently hiringWork at officeLocal areaMonday to Friday
- ...Overview Turn clinical expertise into stronger appeals, better reimbursement, and fewer denials across the enterprise. Work Style: Remote Location Requirement: Must reside in an authorized... ...nursing as a Registered Nurse (RN) or Licensed Practical Nurse (LPN)...Remote workFull timeWork at office
- ...Acting as the liaison for statewide appeals, the full-time RN Licensed Clinical Appeals Coordinator will ensure compliance with State and NCQA requirements... ...letters for member and provider appeals in a fully remote environment. Key responsibilities Review clinical information...Remote workFull time
- ...UnitedHealth Group's UnitedHealthcare division is seeking a Clinical Appeals RN to work remotely from anywhere in the United States. You will analyze appeals and grievances, act as clinical interface liaison, and apply evidence-based criteria to determine coverage decisions...Remote workLocal areaMonday to Friday
- ...UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful patient-care impact....Remote workFull time
- ...Health Business Solutions LLC is seeking a Clinical Appeals Nurse (RN) for a remote role. The position focuses on reviewing denied claims for clinical accuracy and medical necessity, developing appeal strategies, and drafting payer-ready documentation to overturn denials...Remote work
- ...Blue Shield of CA seeks a Clinical Coding Analyst RN, Consultant to support the Facility Compliance Review (FCR) team. You will review post-service prepayment facility claims for contract compliance, medical necessity, and hospital-acquired conditions, supervising two...Remote workContract work
- ...Providing expertise in clinical appeals and grievances, the part-time California Licensed Clinical Appeals RN will review medical records, analyze appeals, and serve as a Clinical Interface Liaison while working remotely on a schedule of M-F with alternating Saturdays....Remote workPart timeWork at office
- ...UnitedHealth Group is seeking a Clinical Appeals RN to provide expert analysis of appeals and grievances, acting as a clinical interface liaison... ...and confidentiality adherence. The position offers remote work from anywhere in the U.S., with an M-F schedule of 8:00...Remote work
- ...Managing clinical appeals from intake through resolution, the full-time contract RN Clinical Appeals Specialist will review documentation, apply clinical nursing knowledge... ...matched-specialty reviews while working remotely in Philadelphia, PA. Key responsibilities Manage...Remote workFull timeContract work
- ...Alliance is seeking a qualified HEDIS Clinical Quality Analyst to provide clinical direction, oversight... ...HEDIS for NCQA and CMS compliance. This remote role supports NC-based policies with... ...in-office meetings. Ideal candidate has RN or LPN licensure and 5+ years of healthcare...Remote workWork at office
- ...CorroHealth, Inc. seeks a Supervisor, Clinical Appeals to lead a denials-management team of Appeal Coordinators supporting Corro Clinical clients. This remote role requires an RN in good standing and strong leadership to mentor staff, manage workflows, and ensure quality...Remote work
- ...UnitedHealth Group is seeking a Clinical Coordinator RN for a Telecommute role in Texas. You will conduct... ...comprehensive clinical reviews of appeals, evaluate medical records, and provide... ...and collaboration within a remote team, with weekday daytime hours. Ideal...Remote workWeekday work
- ...UnitedHealthcare is hiring a Clinical Appeals RN to provide expertise in appeals and grievances, analyze cases, and serve as a Clinical Interface... ...and program definitions while ensuring confidentiality. Remote work is allowed from anywhere in the U.S., with M-F 8:00–4:3...Remote workLocal area
- ...ComplexCare Solutions, Inc. is seeking a Clinical Quality Assurance Analyst (RN-BSN required) for a temporary remote role lasting up to one year. The position focuses on auditing and training to support clinical data standards across the enterprise. The ideal candidate...Remote workTemporary work
$28.94 - $51.63 per hour
...Join us to start Caring. Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals... ...and clarification). You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWeekday work- UnitedHealth Group is seeking a Remote Appeals Clinician in Texas. You will conduct comprehensive reviews... ...), evaluate records, and provide independent clinical judgments on medical necessity. Requirements include a Texas RN license and 2+ years in Medicaid with data-entry...Remote jobFlexible hours
- ...CorroHealth Inc. is seeking a Supervisor, Clinical Appeals to lead the Appeals team in denials management for our clinical clients. You will... ...drive process improvements across workflows. This is a remote position requiring strong leadership, collaboration with payers...Remote work
$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 with healthcare providers and hospital organizations to deliver revenue cycle and accounts receivable support services...Remote jobPermanent employmentFull timeTemporary workPart time$29 - $52 per hour
...Clinical Review ClinicianOptum is a global organization that delivers care, aided by technology... ...as needed to support negotiations and appeals processInteracts with internal business... ...Associate's degreeActive and unrestricted RN license OR LPN in the state of residence2...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLocal area- A national health organization is seeking a Clinical Review Clinician - Appeals to conduct clinical reviews and manage appeals. The role requires an... ...standards and healthcare regulations. The position is fully remote and includes a comprehensive benefits package. Join us...Remote jobFlexible hours
$28 - $51 per hour
About This Role The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances, analyzing, reviewing, and evaluating appeals and grievances, and acting as a Clinical Interface Liaison to resolve issues concerning members, benefits, and...Remote jobFull timeDay shift$62.7k
...assigned or requested. EDUCATION Required ~ Current state RN or LPN license or Bachelor's degree in a Healthcare-related... ...problem-solving skills with the ability to understand and interpret clinical data Language (Other than English): None Travel...Remote workFor contractorsWork at officeLocal area- UnitedHealthcare is hiring a Clinical Appeals RN for remote work Monday-Friday, with alternating Saturdays. The role analyzes appeals and grievances, acts as a clinical liaison, and supports resolution with facilities, providers, and plans. We offer a flexible schedule...Remote jobHourly payWork at officeMonday to FridayFlexible hours
$50.34k - $80.54k
...Job Description We’re hiring an Appeals Analyst to join the Coding Disputes Team! Complete analysis... ...and compliance is met. Gather clinical information by using established criteria... ...– giving you flexibility to work remotely with intentional in-person connection –...Remote workWork at officeLocal areaFlexible hours2 days per week$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- ...the full-time Florida Licensed Clinical Denial Analyst will manage clinical denials and appeals, analyze denied claims, and collaborate... ...departments while working remotely. Key Responsibilities Review, track... ...nursing as a Registered Nurse (RN) in the State of Florida...Remote workFull time
- ...Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for remote work. The role involves evaluating utilization management, reviewing pre/post payment claims, and ensuring adherence to policy across multiple states. A BSN and active RN license are required, with...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote IBR Clinical Appeals Analyst (RN). Be the first to apply!
- fulfillment analyst Saint Paul, MN
- packaging analyst Saint Paul, MN
- incentive compensation analyst Saint Paul, MN
- power bi analyst Saint Paul, MN
- aml analyst Saint Paul, MN
- IT governance analyst Saint Paul, MN
- agriculture analyst Saint Paul, MN
- resource analyst Saint Paul, MN
- facility analyst Saint Paul, MN
- requirements analyst Saint Paul, MN


