Remote RN Medical Claims Reviewer
Broadway Ventures LLC
A leading healthcare consulting firm is seeking a dedicated Registered Nurse (RN) to join the Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with clinical guidelines. The successful candidate will have an active RN license and two years of clinical experience. Strong analytical and communication skills are essential. This position offers a remote work environment with all necessary equipment provided. #J-18808-Ljbffr
$67.7k
...A specialized consulting firm is seeking a Medical Claims Reviewer to conduct medical reviews and provide guidance on claims. This remote role requires an active RN license, a bachelor's degree in nursing, and at least five years of clinical experience. Ideal candidates...Remote workClaimsFull timeMonday to Friday- ...Carolina is looking for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing complex claims... ...established clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical...Remote workClaimsFull time
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review... ...monitor medical necessity using your clinical proficiency and claims knowledge. This is a REMOTE opportunity for candidates...Remote workClaimsFull timeContract workLocal areaShift work
- ...Friday, 8:00 AM – 5:00 PM Location : Remote (U.S. – Work from home) Remote Work... ...a dedicated Registered Nurse (RN) to join our Medical Review team . This role involves conducting... ...Responsibilities Review medically complex claims, pre‑authorization requests, appeals,...Remote workClaimsFull timeFor contractorsWork at officeHome officeMonday to Friday
$65k - $75k
...Overview: Medicare Medical Review RN (Medical Reviewer III) - REMOTE The Medicare Medical Review RN (Medical Reviewer III) will primarily be responsible... ...: Reviews information contained in Standard Claims Processing System files (e.g., claims history, provider...Remote workClaimsFull timeFor contractorsWork at officeLocal areaWorldwideHome office- ...A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing reports, and consulting with medical experts. Candidates must hold an MD/DO or...Remote workClaimsContract work
$46 per hour
...Job Title: Medical Reviewer Location: 100% Remote Duration: 9 months with possible extension Anticipated Hours per week: 20-30 hours Job Description:... ...scientific expertise to commercial teams to support promotional claims audiences to develop and maintain product expertise, and...Remote workClaimsLocal area- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare is... ...vaccine- and countermeasure-related injury claims. These programs provide compensation... ...OR advanced degree (e.g., NP, PA, RN). At least 3 years of experience conducting...Remote workClaimsHourly payContract work
- ...staffing and executive search services. Medical Reviewer / Healthcare Provider – Reasonable... ...Evaluations Job Type: Contract Location: Remote (with occasional U.S. domestic travel... ...Medical consistency between claimed limitations and life activities Impact...Remote workClaimsContract work
$19 per hour
...NOW HIRING: Medical Claims Reviewer Location: Harrisburg, PA (Hybrid – 2 Days Onsite / 3 Days Remote) Pay Rate: $19.00/hour Schedule: Monday – Friday, 8:00 AM – 4:00 PM Overview A-Line Staffing is seeking a detail-oriented Medical Claims Reviewer...Remote workClaimsWork at officeImmediate startMonday to Friday2 days per week- ...UnitedHealth Group is looking for a Secondary Review Nurse in Indiana. This role requires a current RN license and involves evaluating clinical requests for Home... ...and Community-Based Services. The position offers remote work flexibility and responsibilities include...Remote workWork from home
- ...Lead for specialty programs, medical review, utilization management, and... ...through Friday, and is fully remote (Work from Home). This opportunity... ...making and technical claims processing issues. Ensures... ...Microsoft Office. RN, active, unrestricted RN licensure...Remote workClaimsFull timeFor contractorsWork at officeLocal areaWork from homeMonday to Friday
- ...Remote Medical Claims Reviewer (Home Health)United States - RemoteAt Broadway Ventures, we transform challenges into opportunities with expert program... ....Required Licenses and CertificatesActive, unrestricted RN licensure from the United States and in the state of hire,...Remote workClaimsContract workFor contractorsFor subcontractorWork at officeWork from home
- ...Job Type Full-time Description The remote Coder/Specialty Medical Bill Reviewer is responsible for reviewing, auditing, and data entry of... ...for workers' compensation and non-workers' compensation claims, and may include hospital bills, auto liability, and...Remote workClaimsFull timeWork at officeLocal area
- ...Medical Review Specialist III Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct... ...., you will perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare Durable...Remote workClaimsFor contractorsCasual workWork at officeLocal area
- ...050848 Summary Performs medical reviews using clinical/medical information... ...and review of medical claims and utilization practices.... ...onsite training and five weeks of remote training. One week of onsite... ...Youll Need License: Active RN licensure in state hired, OR,...Remote workClaimsFull timeFor contractorsWork experience placementLive inWork at officeLocal areaWork from homeHome officeMonday to FridayShift work
$67.7k
...your trusted partner in innovation. Medical Claims Reviewer Overall Purpose of the Position Broadway... ...Certificates : Active, unrestricted RN licensure from the United States and in... ...Monday to Friday Work Location : remote within three hour driving radius of Augusta...Remote workClaimsFull timeContract workFor contractorsLive inWork at officeWork from homeHome officeMonday to FridayFlexible hoursShift work$62.7k - $100.4k
...Job Summary: The Program Integrity Medical Coding Reviewer III supports most complex medical record audit programs, dispute management,... ...strong relationships with cross departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal...Remote workClaimsHourly payWork experience placementWork at office- Itemized Bill and Medical Record Reviewer job at Alaffia Health. New York, NY. About... ...have experience reviewing claim forms and auditing provider... ...Clinical license required (RN) preferred Experience working... ...access to Leadership LI-REMOTE #J-18808-Ljbffr Alaffia HealthRemote workClaimsFlexible hours
- ...Medical Reviewer Join our team serving active and retired US military members... ...and review of medical claims and utilization practices.... ...Friday. This position will be remote after 6 months of training.... ...software. Active, unrestricted RN licensure from the United States...Remote workClaimsFor contractorsWork at officeLocal areaMonday to FridayNight shift
$47 - $50 per hour
...Medical Reviewer/Safety Reviewer III Contract: 1 year with possible extension Hourly Rate... ...election and location) Location: Remote (candidates need to be located in the USA... ...colleagues on proper product and disease state claims development. 2. Engage with Medical...Remote workClaimsHourly payContract workWork at officeWorldwideVisa sponsorshipWork visa- ...A leading medical service provider in Washington, DC is seeking a DME Medical Reviewer to ensure compliance with nursing standards and provide... ...candidate must hold an active RN license and have at least two... ...audits. The role emphasizes remote work capabilities and...Remote work
$47.06k - $70.24k
...solutions provider is seeking a Utilization Review Nurse in Fort Worth, TX. This remote role involves analyzing medical bill appropriateness, documenting findings, and communicating with claims examiners. Candidates must have a current RN license and at least four years of...Remote workClaims- ...outcomes. Our talented remote workforce spans the... ...benefits that include: Medical, dental and vision... ...Role: Lead Clinical Reviewer DC Medicaid Contract... ...of medical records and claims. The role requires collaboration... ...field. Active RN licensure. Minimum...Remote workClaimsContract work
- ...A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Remote workClaimsFull time
$68.97k - $113.31k
Guardian Life is seeking an RN Clinical Consultant to serve as a clinical resource for assessing disability claims. The role involves reviewing claims, collaborating with healthcare providers... ...and is open to candidates in the United States or fully remote. #J-18808-LjbffrRemote workClaims- ...intelligence company is seeking a Nurse Itemized Bill Reviewer to analyze medical claims and ensure compliance with industry standards. This remote position allows candidates to work from... ...candidates should possess an active RN, LPN, or LVN license, along with at least 1...Remote workClaims
- ...Registered Nurse. Key Responsibilities Review medical records and documentation for compliance... ...detailed workpapers Required Qualifications RN license preferred; Indiana or compact... ...least 1 year of experience in Medicaid claims review or healthcare reimbursement...Remote workClaims
- ...Role: Clinical RN I - Pre/Post Pay Audit Location: Remote (NJ, NY, PA, CT, DE) Job Summary Performs... ...validation, and compliance with medical necessity criteria. Follows defined... ...audits using standard guidelines Review claims, clinical documentation, and...Remote workClaims
- ...established industry player is seeking a Medical Review Nurse to join their dynamic team in... ...involves reviewing and adjudicating medical claims, ensuring compliance with industry standards... ...enjoying the flexibility of a primarily remote work environment. If you are passionate...Remote workClaims
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