Average salary: $71,961 /yearly

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Job Description: PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing... 
Medical
Immediate start

Revive Staffing Solutions Inc

Remote
25 days ago
 ...Remote The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care. Clinical and/or technical expertise is... 
Medical
Minimum wage
Full time
Local area
Remote job
Flexible hours

CorVel Corporation

Remote
12 hours ago
 ...particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to...  ...by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines.... 
Medical
Remote job
Flexible hours

Cohere Health

Remote
4 days ago
 ...Target PR Range: 29-39/hr *Depending on experience JOB SUMMARY: 1. Will electronically review promotional materials and other materials and will provide medical expertise and expert review as described above. Including discussing and collaborating with appropriate... 
Medical
Remote job
Contract work

Planet Group

Remote
1 day ago
 ...Medical Claims Review Nurse Position is fully remote Schedule: M-F 9AM-5PM local time. The training schedule will be M-F 9AM-5PM EST. Daily responsibilities: Candidates will be reviewing medical patient records against standard medical criteria. Candidates MUST... 
Medical
Local area
Remote job

Morgan Stephens

Remote
a month ago
 ...Location: Must reside within the Contiguous United States Hours: M-F, 8:00 AM - 5:00 PM EST Job Description: As a Desktop Reviewer/Applications Processor our successful team members perform in a variety of exciting areas geared towards delivering an exceptional... 
Suggested
Remote job
Full time

AdNet AccountNet, Inc.

Remote
6 days ago
 .... Licensing: US any bar in good standing acceptable. Experience: A minimum of 6 months experience working on remote document reviews; experience with eDiscovery platform, relativity preferred. Experience with 1st level; (2nd level, Priv., QC preferred). Please... 
Suggested
Remote job
Work from home

Consilio - Enterprise Talent Solutions

Remote
11 days ago
 ...to protect and promote public health by conducting Systematic Reviews (SRs) in a wide variety of clinical content areas. Joining the...  ...opportunity to help inform decisions related to pharmacological and medical devices and thus improve the lives and well-being of millions... 
Suggested
Remote job
Holiday work
Full time
Local area
Work alone
Flexible hours
Shift work

International Consulting Associates, Inc.

Remote
a month ago
 ...follow the trends. We set them. Job Summary As a Tech Review Adjuster , you will enjoy the flexibility of working from the...  ...Competitive salary based on experience and qualifications Medical, dental, and vision coverage Allstate pension plan and 401(k... 
Medical
Remote job
Full time
Contract work
Work from home
Home office
Work visa
Relocation bonus

Allstate Insurance Company

Remote
12 hours ago
 ...ABOUT THE ROLE As a Document Quality Review Specialist (Reporting Specialist), you will provide high-level operations support to the service delivery organization by working to assemble, format, and review time-sensitive and highly technical reports. The ability to... 
Suggested
Remote job
Holiday work
Full time

A-LIGN External

Remote
10 hours ago
 ...Desktop Application Reviewer/Auditor About Us AdNet/AccountNet, Inc. is an 8(a), WOSB, LGBTE and WBE owned management consulting firm founded in 1990. We blend the best in people with the ongoing demands of the workplace by providing high quality staffing and executive... 
Suggested
Remote job
Full time
For contractors
Flexible hours

AdNet AccountNet, Inc.

Remote
6 days ago
 ...death of a loved one, depression/anxiety, and other traumatic events. This system flags about 1% of reflections for a thoughtful human review before sending out alerts to the concerned teachers, admins and counselors. We are looking to hire highly skilled, thoughtful and... 
Suggested
Remote job
Hourly pay
Internship
Flexible hours

Sown To Grow

Remote
6 days ago
 ...Job Description: Content Quality Reviews: Participate in first-level reviews of the produced content and ensure appropriateness of subject matter, language, writing style and other content elements Provide constructive feedback so as to improve the quality... 
Suggested

Acme Services Private Limited

Remote
a month ago
 ...technologies and operations has an exciting opening for a Fraud Review Analyst.  Radial’s omnichannel solutions use cutting-edge...  ...for employment without regard to age, ancestry, color, family or medical care leave, gender identity or expression, genetic information,... 
Medical
Remote job
Full time

Radial Inc.

Remote
22 days ago
 ...Job Summary: The Program Integrity Medical Coding Reviewer II is responsible for review of vendor audit activities, pended claim work queues, medical records work queues as well as claim reviews for provider pre-payment and post-payment functions. Experience with DRG... 
Medical
Remote job
Full time
Work experience placement

CareSource

Remote
more than 2 months ago
Accreditation Reviewer and Educator Department: Care Management Services (130) Location: Remote, DC Major purpose of this...  ...(List the minimum requirements for the position.) ~Registered Nurse with a Bachelor’s degree in a health-related field (Master’s Degree... 
Remote job

URAC

Remote
a month ago
 ...analytical candidate with good time management and reasoning skills who can work ad hoc as we have estate plan drafts that need to be reviewed and finalized for attorneys in our drafting program. The primary task for this position is reviewing, editing, and finalizing... 
Remote job
Flexible hours
Weekday work

Legacy System

Remote
24 days ago
Job DescriptionThe School of Medical Imaging and Therapeutics seeks an Adjunct faculty member to deliver high-quality learning experiences...  ...on-line, asynchronously. Subject matters include literature review, designing a research hypothesis and protocol, interpreting and... 
Medical
Work experience placement
Work visa

Massachusetts College of Pharmacy and Health Sciences

Remote
18 days ago
 ...general liability, cyber liability, professional liability, umbrella, and property policies. Strong skills in contract analysis and review are crucial. Candidates should be able to assess insurance requirements within contracts, identify potential risks, and suggest... 
Contract work

BSD Business Consulting

Remote
a month ago
 ...Right Discovery is seeking licensed attorneys for a remote data breach/ cyber breach review project Responsibilities include:  Identifying documents with personal information and personal health information per client instructions  Input PII/PHI into database... 
Remote job

Right Discovery

Remote
7 days ago
 ...care prior to hospitalization utilizing medical necessity criteria and third party payer...  ...knowledge of care management, utilization review changes, authorization changes, contract...  ...for currently employed UR's) 2-3 years nursing experience with 1 year in Utilization Management... 
Medical
Full time
Contract work
Local area
Immediate start

Allegheny Health Network

Remote
a month ago
 ...based on the Scrum and Agile methodologies; dev-friendly processes such as Continuous Integration, Continuous Delivery, Code Review, and bug bashes; working as a team to solve common issues Benefits In return, we offer: ~100% remote, flexible... 
Full time
Freelance
Remote job
Flexible hours

Netguru

Remote
21 days ago
 ...with the potential to extend. Skills and Qualifications : ~5+ years of public accounting experience ~3+ years of experience reviewing tax returns ~ CPA, Enrolled Agent, or Master in Taxation preferred ~ Active PTIN ~ Technical tax competencies in preparing... 
Remote job
Full time
Contract work
Part time
Freelance

Beech Valley Solutions

Remote
a month ago
 ...Research Analyst II, Systematic Reviews - International Consulting Associates, Inc. (Remote) About ICA International Consulting...  ...opportunity to help inform decisions related to pharmacological and medical devices and thus improve the lives and well-being of millions... 
Remote job
Holiday work
Full time
Local area
Work alone
Flexible hours
Shift work

International Consulting Associates, Inc.

Remote
a month ago
We are looking for a Senior Security Code Reviewer to join our client’s team in support of a large cyber security program with their federal customer. In this role, you will be responsible for performing security activities associated with reviewing source code, both... 
Remote job

Shedd RS

Remote
22 days ago
 ...Description Job Description Remote Inpatient Medical Coder - Facility Coding Why Join Us?...  ...regulations. Key Responsibilities Review and analyze inpatient medical records...  ...professionals, including physicians and nurses, to clarify documentation and gather supplementary... 
Medical
Remote job
Hourly pay
Flexible hours

QPA Healthcare

Remote
11 days ago
 ...Job Summary: The Program Integrity Clinical Reviewer II contributes to the investigative process by evaluating medical records, looking for correct documentation, trends, patterns, missing information, upcoding, unbundling, etc. in relation to clinical documentation... 
Medical
Remote job
Full time
For subcontractor

CareSource

Remote
more than 2 months ago

$95k - $120k

 ...- Prosystem - Partnership - S Corp - C Corp - Tax Returns - Tax Planning What's In It for You - Vacation/PTO - Medical - Dental - Vision - Bonus - 401k Benefits - Vacation/PTO - Medical - Dental - Vision - 401k - Bonus So,... 
Medical
Full time

CyberCoders

Remote
more than 2 months ago
 ...Contract Review Attorney - eDiscovery Our company handles a large number of e-Discovery cases and for a multitude of clients. We have the only privately run FBI certified e-forensics lab in the country. We host data as a Relativity licenser. Benefits of working... 
Remote job
Full time
Contract work
Flexible hours

Ricoh E-Discovery

Remote
6 days ago
 ...candidate that meets the minimum requirements   Academic Progress Review Specialists are primarily responsible for reviewing SAP (...  ...which are highlighted below: ~ Competitive compensation and medical/dental benefit plans ~401(k) participation with possible employer... 
Medical
Full time
Immediate start
Remote job

ECPI University

Remote
more than 2 months ago