Top 48 Rn medical coder Jobs in Remote

DRG Reviewer
Machinify —Remote
- $90,000 - $115,000 a year
- Remote
- Nursing
- RN License
- HIPAA
- Health savings account
- Health insurance
Quick Apply
Medical Billing - Quality Assurance - Digitech - Remote
Sarnova —Remote
- Full-time
- Remote
- Computer literacy
- Mid-level
- High school diploma or GED
- 401(k)
Quick Apply
LPN/RN Certified Professional Coder (CPC)
Managed Care Network, Inc. —Remote
- $52,000 - $70,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- RN License
Quick Apply
6d
DRG Clinical Validation Nurse
MedReview —Remote
- $85,000 - $95,000 a year
- Full-time
- Remote
- Anatomy knowledge
- RN License
- Computer literacy
- Commuter assistance
- Health insurance
Clinical Documentation Integrity (CDI) Analyst (Remote)
University Hospitals —Shaker Heights, OH
- $79,331 - $124,051 a year
- Remote
- Nursing
- Medicine
- RN License
Clinical Documentation Integrity Specialist - Remote
Med-Metrix —Remote
- Full-time
- Remote
- Nursing
- Doctoral degree
- RN License
Certified Professional Coder/ DRG Specialist
Managed Care Network, Inc. —Remote
- $50,000 - $70,000 a year
- Part-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
6d
CDI Consultant
e4health —Remote
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Disability insurance
- Health insurance
Claims Auditor, Reviewer and Coder
Planned Systems International, Inc. —Remote
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 5 years
- AD&D insurance
- Disability insurance
CDI Consultant (PT)
e4health —Remote
- Part-time
- Remote
- Nursing
- Medicine
- Microsoft Outlook
- Disability insurance
- Health insurance
IDR Coder Reviewer
Commence —Virginia Beach, VA
- $45 - $70 an hour
- Part-time
- Remote
- Writing skills
- HIPAA
- Research
Clinical Documentation Improvement (CDI) Specialist
Exceptional Healthcare Inc. —Remote
- Full-time
- Nursing
- RN License
- Hospital
Medical Review Auditor (Fraud Waste and Abuse)
Cotiviti —Remote
- $70,000 - $91,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Paid holidays
- Disability insurance
7d
Clinical Documentation Specialist
Singing River Health System —Jackson, MS
- Weekends as needed
- Remote
- Nursing
- Microsoft Outlook
- RN License
Quick Apply
CDI Consultant (FT)
e4health —Remote
- Full-time
- Remote
- Nursing
- Medicine
- Microsoft Excel
- Disability insurance
- Health insurance
YM New Provider Auditor and Educator
Yale University —New Haven, CT
- $82,000 - $131,500 a year
- Full-time
- Remote
- Microsoft Word
- Background check
- Anatomy knowledge
Clinical Documentation Specialist
UNC Health Blue Ridge —Morganton, NC
- Full-time
- Remote
- RN License
- Mid-level
- 3 years
- Tuition reimbursement
Quick Apply
Clinical Coding Appeals Nurse
R1 RCM, Inc. —Remote
- $65,000.00 - $116,747.20 a year
- Full-time
- Nursing
- RN License
- 5 years
3d
Special Investigations Unit Pre Pay Coding Consultant
Optum —Plymouth, MA
- $24 - $43 an hour
- Overtime
- Remote
- 18 years or older
- Anatomy knowledge
- RN License
- Paid training
- On-the-job training
CDI Specialist III - Inpt
SYSTEM West Virginia University Health System —Remote
- Full-time
- Anatomy knowledge
- Hospital
- Office

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DRG Reviewer

Machinify -
Remote

Quick Apply

Job Details

$90,000 - $115,000 a year

Benefits

Health savings account
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching

Qualifications

Root cause analysis
DRG

Full Job Description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity

As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. This position requires an in-depth understanding of clinical guidelines, coding protocols, and regulatory requirements to ensure accurate payment determinations.

In this role, you will meticulously document findings, provide detailed clinical, policy, and regulatory support and collaborate with relevant stakeholders to ensure compliance with payment standards. Your expertise will be critical in ensuring that payment decisions are supported by accurate and complete documentation, ultimately contributing to the integrity and efficiency of the payment process.

What you'll do

Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.
Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.
Collaborate with team leaders to ensure thorough review of DRG denials.
Conduct audits in alignment with organizational quality and timeliness standards.
Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters.
Recommend improvements to the audit system to enhance efficiency.
Ensure compliance with HIPAA regulations for protected health information.
Perform other duties as assigned.

What you bring (Role Requirements)

Education Requirements:

An associate or bachelor's degree is required (in nursing or in health information management is preferred).
Work experience may be considered in lieu of formal education at leadership discretion.

License / Certification (at least one of the following is required)

RN – Registered Nurse (active/unrestricted license)
RHIA – Registered Health Information Administrator
RHIT – Registered Health Information Technician
CCDS – Certified Clinical Documentation Specialist
CDIP – Clinical Documentation Improvement Practitioner
CCS – Certified Coding Specialist
CIC – Certified Inpatient Coder

Qualifications:

Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more.
Strong focus on quality and attention to detail.
Deep curiosity and analytical skills to understand root causes of events and behaviors.
Proven ability to apply critical judgment in clinical and coding determinations.
In-depth knowledge of clinical criteria and documentation requirements to support code assignments.
Expertise in DRG methodologies (e.g., MS & APR), ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA's Coding Clinic Guidelines.
Experience with readmission and/or short-stay reviews, and/or familiarity with InterQual and/or MCG (Milliman) criteria, is a plus.
Ability to work independently and efficiently with minimal supervision.

What We Offer:

Work from anywhere in the US! Machinify is digital-first.
Top Medical/Dental/Vision offerings
FSA/HSA
Tuition reimbursement
Competitive salary, 401(k) with company match
PTO
Additional health and wellness benefits and perks
Flexible and trusting environment where you'll feel empowered to do your best work

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.

Pay range: $90,000 - $115,000, plus quarterly bonus.

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

Quick Apply

Refine Your Search

rn medical coder jobs in remote

DRG Reviewer

Medical Billing - Quality Assurance - Digitech - Remote

LPN/RN Certified Professional Coder (CPC)

DRG Clinical Validation Nurse

Clinical Documentation Integrity (CDI) Analyst (Remote)

Clinical Documentation Integrity Specialist - Remote

Certified Professional Coder/ DRG Specialist

CDI Consultant

Claims Auditor, Reviewer and Coder

CDI Consultant (PT)

IDR Coder Reviewer

Clinical Documentation Improvement (CDI) Specialist

Medical Review Auditor (Fraud Waste and Abuse)

Clinical Documentation Specialist

CDI Consultant (FT)

YM New Provider Auditor and Educator

Clinical Documentation Specialist

Clinical Coding Appeals Nurse

Special Investigations Unit Pre Pay Coding Consultant

CDI Specialist III - Inpt

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