Top 200 Medical claims reviewer remote Jobs

Auto Reviewer Variable - Virtual & Desk
Alacrity Claims Solutions, LLC —Remote
- From $40,000 a year
- Overtime
- Background check
- Customer service
- Computer literacy
- Health savings account
- Health insurance
Quick Apply
Remote Home Health RN – Medical Claims Reviewer
Broadway Ventures —Remote
- $60,000 - $63,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Customer service
Quick Apply
Audit Reviewer (RN -Med/Surg)
Knowtion Health —Remote
- Full-time
- Remote
- Mid-level
- 3 years
- Medical-Surgical
- Paid holidays
- Disability insurance
Quick Apply
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
Medical Claim Reviewer (CGS, DMEC-B)
Broadway Ventures —Remote
- $31.25 an hour
- Remote
- Nursing
- RN License
- Customer service
Quick Apply
Initial Clinical Reviewer - Remote - AZ
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- LMFT
- Nursing
- RN License
Business Analyst, Regulatory Reporting Solutions (Remote)
CVS Health —Mississippi
- $43,888 - $102,081 a year
- Full-time
- Remote
- Mid-level
- Bachelor's degree
- Data entry
- Health insurance
- Dental insurance
Prior Authorization Medical Clinician
WellSense Health Plan —Remote
- $35.58 - $51.44 an hour
- Weekends as needed
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
7d
Reviewer II, Medical
BlueCross BlueShield of South Carolina —South Carolina
- Full-time
- Remote
- Nursing
- RN License
- Customer service
- Paid holidays
- Health insurance
Coordinator, UM Intake
Evolent Health —Remote
- $18 - $20 an hour
- Full-time
- Background check
- Computer literacy
- Pass drug screening
- Health insurance
Inpatient DRG Reviewer
Zelis —Saint Petersburg, FL
- $79,000 - $99,750 a year
- Full-time
- Hybrid work
- LVN
- RN License
- Mid-level
- Paid holidays
- Disability insurance
Nurse Itemized Bill Reviewer (IBR Analyst)
Machinify —California City, CA
- $80,000 - $90,000 a year
- Remote
- Microsoft Excel
- LVN
- RN License
- Health savings account
- Health insurance
BH UM Clinical Reviewer- Remote AZ
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- Mid-level
- Organizational skills
- 1 year
8d
DRG Nurse Reviewer Appeals and Hearings- Remote
Gainwell Technologies —Florida
- $95,000 - $110,000 a year
- Full-time
- Remote
- RN License
- Presentation skills
- Travel
- Health insurance
- Tuition reimbursement
Client Coordinator
MES Solutions —Atlanta, GA
- $17 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- 401(k)
- Paid time off
Quick Apply
Physician Reviewer
MedReview —Remote
- $230,000 a year
- Full-time
- Remote
- Medicine
- 5 years
- BC/BE
Quick Apply
Freelance Medical & Billing Coder
Dane Street, LLC —Orlando, FL
- Medical office experience
- Mid-level
- Quality control
Quick Apply
Remote RN – Medical Claims Reviewer
Broadway Ventures —Nashville, TN
- $31.25 an hour
- Full-time
- Remote
- Nursing
- RN License
- Customer service
Quick Apply
Medicaid Program Specialist 3 (Surveillance Utilization Reviewer-PCN 060246)
State of Alaska —Anchorage, AK
- $6,238.50 a month
- Full-time
- Hybrid work
- English
- Research
- Office
- Vision insurance
7d
Utilization Review & Quality Assurance Specialist
ExamWorks —Rockford, IL
- $45 - $52 an hour
- Full-time
- Remote
- Anatomy knowledge
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
2d

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Auto Reviewer Variable - Virtual & Desk

Alacrity Claims Solutions, LLC
Remote

Quick Apply

Job Details

Full-time
From $40,000 a year

Benefits

Health savings account
Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance

Qualifications

Estimating software
Confidential information handling
Computer literacy
Estimating software for insurance claims
High school diploma or GED
Computer-aided vehicle damage estimating
Estimating for automotive body repair

Full Job Description

Auto Reviewers will determine the scope and cost of auto repairs for damage caused by collision or other risks. The appraiser reviews shop estimates and/or photos of the damaged vehicle. and works to reach a mutually acceptable repair estimate with the repair facility based on client guidelines and industry standards.

Essential Functions

Review repair assignments received from insurance carriers
Compare repair estimates with supporting documentation submitted by auto repair facilities
Analyze repair procedures, labor operations, and parts usage for accuracy and compliance
Apply carrier guidelines, industry standards, and best practices when rewriting estimates
Utilize estimating software to prepare and revise repair estimates
Communicate with repair facilities to discuss estimate discrepancies and negotiate agreed repair pricing
Complete estimate reviews and assemble reporting documentation for client submission
Maintain accurate and timely documentation within company systems
Meet individual and team productivity, quality, and cycle time goals
Ensure compliance with company policies, carrier requirements, and industry regulations
Provide professional customer service and maintain positive working relationships with repair facilities and clients

Competencies

Strong knowledge of collision repair processes and estimating procedures
Proficiency with CCC/Pathways estimating software or equivalent platforms (Audatex, Mitchell, WebEst, PenPro, etc.)
Excellent negotiation and communication skills
Strong attention to detail and analytical abilities
Effective time management and organizational skills
Ability to work independently and manage multiple assignments simultaneously
Problem-solving and decision-making skills
Computer proficiency and system navigation skills
Ability to interpret repair documentation, photos, and estimates accurately
Professionalism and customer service orientation

Work Environment

This position operates in a remote work-from-home environment requiring adherence to company security, privacy, and confidentiality protocols. Employees are required to maintain a professional and secure workspace free from distractions and unauthorized access.

Employees may be required to:

Use company-issued computer equipment and approved systems
Maintain a hardwired ethernet internet connection; Wi-Fi connections are not permitted
Ensure reliable high-speed internet service that meets company requirements
Follow all company data security, confidentiality, and clean desk policies
Work in a quiet and secure environment suitable for handling confidential insurance and customer information
Comply with insurance carrier and company security standards
Participate in virtual meetings, training sessions, and team collaboration activities
Work scheduled business hours with occasional overtime based on workload demands

Physical & Mental Demands

Prolonged periods of sitting and computer use
Frequent keyboarding, screen viewing, and telephone communication
Ability to review detailed repair estimates and documentation for extended periods
Ability to manage multiple assignments in a deadline-driven environment
Strong concentration and analytical focus required
Ability to communicate professionally during negotiations and dispute resolution conversations

Travel Required

Applicants will be required to travel to a designated training location for one week of onsite training at company expense
Following onsite training, employees will complete an additional two weeks of remote/work-from-home training
Total training duration is approximately three weeks

Required Education & Experience

High school diploma or equivalent required
At least 6 months’ experience with CCC/Pathways estimating software or its equivalent (Audatex, Mitchell, WebEst, etc.)
Strong understanding of collision repair estimating practices and insurance repair procedures
Ability to accurately document estimate reviews and repair recommendations

Preferred Education & Experience

Additional insurance claims or collision repair industry experience preferred
Prior experience working directly with insurance carriers preferred
Associate degree or technical training in automotive collision repair preferred
Experience in virtual or desk review estimating environments preferred

Additional Eligibility Requirements

Current Appraiser, Adjuster, or I-CAR certification required
Ability to pass background screening and employment verification requirements
Ability to maintain confidentiality of client and carrier information
Reliable attendance and schedule flexibility required
Must comply with all company policies, procedures, and carrier guidelines

Affirmative Action/EEO Statement

Alacrity Solutions is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, and training. Alacrity Solutions makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, please refer to our EEO policy.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Good-Faith Estimate (including bonus or commission)

The posted compensation range represents an estimate and may include both base salary and variable components such as commission and performance-based bonuses. Total compensation will ultimately be determined based on the candidate’s experience and qualifications.

General Description of Benefits

Alacrity Solutions offers a comprehensive benefits package, including but not limited to medical, dental, and vision coverage, paid time off, a health savings account, and an employee assistance program.

Work Schedule

Full Time, 80.00 hours per pay period (2 weeks)

How to Apply

Click the Apply button on this site. You will be linked to the Alacrity Solutions Career Page. Our career page can be found at https://www.alacritysolutions.com/about/careers/#current

Personal Information Retention Policy

Personal information will be retained for a minimum period of one year in accordance with applicable policies and regulatory requirements.

Post Closing Date

This position will be open for a minimum of three days and until a top applicant is identified.

Quick Apply

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medical claims reviewer remote jobs

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