Top 322 Medical insurance reviewer Jobs in Remote

Second Level Reviewer I PRN Remote
AdventHealth Corporate —Altamonte Springs, FL
- $31.82 - $59.17 an hour
- PRN
- Remote
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Clinical Appeals Reviewer
UnitedHealthcare —Dallas, TX
- $18 - $32 an hour
- 8 hour shift
- Remote
- 18 years or older
- Microsoft Outlook
- Pass drug screening
- Paid training
- On-the-job training
1d
Dispute Resolution Reviewer I
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Research
- Mid-level
- Associate's degree
- AD&D insurance
- Disability insurance
Dispute Resolution Reviewer III (Healthcare Professional)
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Utilization Review Specialist (Remote)
The Florida House —Deerfield Beach, FL
- Per diem
- Remote
- Nursing
- Addiction Medicine
- Mid-level
- Continuing education credits
- Disability insurance
Quick Apply
7d
Shared Services Specialist
Private Health Management —Remote
- $26.44 - $31.25 an hour
- Remote
- Research
- Mid-level
- Bachelor's degree
- Dental insurance
- Paid time off
Quick Apply
5d
Dispute Resolution Analyst
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Administrative experience
- High school diploma or GED
- Business Administration
- AD&D insurance
- Disability insurance
Product Reviewer
G-MED NORTH AMERICA, Inc. —Remote
- Full-time
- Remote
- Mid-level
- 4 years
- Commuter assistance
- Paid parental leave
Quick Apply
Diagnostic Radiology- Medical Record Reviewer
Dane Street, LLC —Minneapolis, MN
- Remote
- BC/BE
- Senior level
- Radiology
Quick Apply
Cardiology Clinical Reviewer
Cohere Health —Remote
- $120,000 - $135,000 a year
- Mid-level
- 3 years
- Travel
- Paid parental leave
- Health savings account
Quick Apply
RN Reviewer
Cohere Health —Remote
- $33 - $35 an hour
- Weekends as needed
- Remote
- Google Workspace
- Nursing
- RN License
- Paid parental leave
- Health savings account
Quick Apply
Medical Claim Reviewer (CGS, DMEC-B)
Broadway Ventures —Remote
- $31.25 an hour
- Remote
- Nursing
- RN License
- Customer service
- Disability insurance
- Dental insurance
Quick Apply
Medical Writer
Biodesix, Inc. —Remote
- $90,000 - $130,000 a year
- Full-time
- Remote
- Mid-level
- 3 years
- Databases
- Paid holidays
- Disability insurance
Quick Apply
6d
Utilization Review Specialist
We Level Up —Pompano Beach, FL
- $50,000 - $90,000 a year
- Full-time
- Remote
- 18 years or older
- CPR Certification
- HIPAA
Quick Apply
Clinical Pharmacy Coordinator (Remote)
MRIoA —Remote
- Full-time
- Remote
- Microsoft Word
- Background check
- Anatomy knowledge
- Paid holidays
- Health insurance
Quick Apply
Lead RN Reviewer
Cohere Health —Remote
- $35 - $37 an hour
- Remote
- Nursing
- RN License
- Continuous improvement
- Paid parental leave
- Health savings account
Quick Apply
Physician Reviewer Multiple Specialties - TEXAS and NEW MEXICO
Federal Hearings And Appeals —Wilkes-Barre, PA
- Contract
- Remote
- Medicine
- Surgery
- Addiction Medicine
Quick Apply
Senior Premium Insurance Audit Reviewer
ReSource Pro —Remote
- $46,518 - $78,967 a year
- Full-time
- 5 years
- High school diploma or GED
- Continuous improvement
- Wellness program
- Health savings account
Quick Apply
Senior Insurance Product Compliance Professional-Remote
Humana —Remote
- $78,400 - $107,800 a year
- Full-time
- Remote
- Microsoft Excel
- 5 years
- Bachelor's degree
- Paid parental leave
- Paid holidays
6d
Clinical Appeals Coord
Independence Blue Cross —Remote
- Nursing
- RN License
- 5 years

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medical insurance reviewer jobs near remote

Second Level Reviewer I PRN Remote

AdventHealth Corporate -
Altamonte Springs, FL

Apply Now

Job Details

PRN
$31.82 - $59.17 an hour

Benefits

Paid parental leave
Disability insurance
Health insurance
Dental insurance
Paid time off
Parental leave
Vision insurance
403(b)
Benefits from day one
Life insurance

Qualifications

Triage
Acute care facility experience
Typing

Full Job Description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits

Schedule:

PRN

Shift:

Day (United States of America)

Address:

900 HOPE WAY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

Job Description:

Reviews concurrent medical records for documentation compliance, including completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality. Completes accurate and timely record reviews to ensure the integrity of documentation compliance. Inputs data into CDI Software accurately and concisely, resulting in precise metrics obtained through the reconciliation process. Recognizes opportunities for documentation improvement using strong critical-thinking skills and sound judgment. Initiates and formulates CDI severity worksheets and clinically credible clarifications for inpatients, presenting opportunities for improved documentation compliance to physicians, nurse practitioners, and other clinical team members. Transcribes documentation clarifications as appropriate for SOI, ROM, PSI, HCCs, and HACs to ensure documentation compliance. Educates members of the patient-care team regarding documentation regulations and guidelines, including physicians, allied health practitioners, and nursing, with quarterly and annual compliance updates from Medicare. Communicates effectively and appropriately with physicians and other healthcare providers to ensure accurate and complete clinical documentation. Collaborates with HIM staff to resolve discrepancies with DRG assignments and other coding issues. Completes well-timed follow-up case reviews on all cases, prioritizing resolution of those with clinical documentation clarifications. Participates in department meetings, providing feedback on outstanding issues, presentations for educational opportunities, and addressing needs identified by CDI leaders. Assumes personal responsibility for professional growth, development, and continuing education to maintain a high level of proficiency. Performs other duties as assigned.

Knowledge, Skills, and Abilities:

Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrates excellent physician relations. [Required]
Able to organize and present information clearly and concisely; excellent computer and keyboarding skills; ability to use multiple software programs simultaneously; high degree of prioritization skills. [Required]
Ability to learn/develop and fine-tune the skills necessary to perform optimally as a Clinical Documentation Specialist. [Required]
Dependable, self-motivated and pleasant. [Required]
Utilize and demonstrate excellent critical-thinking, problem-solving and deductive-reasoning skills. [Required]
Knowledge of pathophysiology, disease processes and treatments. [Required]
Strong ability to organize/triage work and manage multiple priorities at once. [Required]
Knowledge of clinical documentation requirements that identify clinical conditions or procedures. [Preferred]
Coding background. [Preferred]
Knowledge of quality guidelines. [Preferred]

Education:

Bachelor's of Nursing [Required]
Master's [Preferred]

Field of Study:

in healthcare related field

Work Experience:

5+ years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience. [Required]
3+ years of Clinical Documentation Specialist experience [Required]

Additional Information:

An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:- BSN and 3+ years of Clinical Documentation Specialist experience OR - 4+ years of Clinical Documentation Specialist experience OR - Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience.

Licenses and Certifications:

Registered Nurse (RN) [Required] OR
Physician Assistant (PA) [Required] OR
Advanced Practice Registered Nurse (APRN) [Required] OR
Certified Clinical Documentation Specialist (CCDS) [Required]
Certified Billing and Coding Specialist (CBCS) [Preferred]
Certified Cardiac Device Specialist (CCDS) [Required]

Physical Requirements: (Please click the link below to view work requirements)

Physical Requirements -https://tinyurl.com/23km2677

Pay Range:

$31.82 - $59.17

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Apply Now

Refine Your Search

medical insurance reviewer jobs in remote

Second Level Reviewer I PRN Remote

Clinical Appeals Reviewer

Dispute Resolution Reviewer I

Dispute Resolution Reviewer III (Healthcare Professional)

Utilization Review Specialist (Remote)

Shared Services Specialist

Dispute Resolution Analyst

Product Reviewer

Diagnostic Radiology- Medical Record Reviewer

Cardiology Clinical Reviewer

RN Reviewer

Medical Claim Reviewer (CGS, DMEC-B)

Medical Writer

Utilization Review Specialist

Clinical Pharmacy Coordinator (Remote)

Lead RN Reviewer

Physician Reviewer Multiple Specialties - TEXAS and NEW MEXICO

Senior Premium Insurance Audit Reviewer

Senior Insurance Product Compliance Professional-Remote

Clinical Appeals Coord

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