Remote Medical Necessity Jobs

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SuperCare Health (USA)
Customer Care Specialist at SuperCare Health
Today

SuperCare Health (USA) - SME

New
Remote from
Austria, Arizona (USA)
Full time
Medical Necessity
Computerized Physician Order Entry
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Centene Corporation
Remote Outpatient Medical Director
Today

Centene Corporation - XLarge

New
Remote from
Missouri (USA)
Full time

Expert & Leadership (>10 years)

Credential Manager
Utilization Management
Medical Management
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PGBA
LPN Medical Reviewer (Myrtle Beach, Remote after 6 months)
Today

PGBA

New
Remote from
South Carolina (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Medical Insurance Claims
Clinical Assessments
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The Clinic by Cleveland Clinic
Pharmacy Authorization Representative II
Today

The Clinic by Cleveland Clinic

New
Remote from
United States
Full time

Mid-level (2-5 years)

48 - 48K
Pharmacy Benefit Management
Medical Necessity
Prior Authorization
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LCMC Health
CDM Analyst - Revenue Integrity - Remote
Today

LCMC Health - XLarge

New
Remote from
United States
Full time

Mid-level (2-5 years)

ICD Coding (ICD-9/ICD-10)
CPT Coding
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Blue Cross NC
Episodic Care Manager - Medicare
1 day ago

Blue Cross NC - Insurance - XLarge

Remote from
North Carolina (USA)
Full time

Senior (5-10 years)

Clinical Data Analysis
Utilization Management
Medical Necessity
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Personify Health
Utilization Review Nurse-RN
Today

Personify Health - TPE

New
Remote from
United States
Full time

Junior (1-2 years)

48 - 48K
Utilization Management
Prior Authorization
Medical Necessity
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Centene Corporation
Clinical Review Clinician - Appeals
Today

Centene Corporation - XLarge

New
Remote from
United States, Canada, Arizona (USA) +9
Full time

Senior (5-10 years)

Medical Record Management
Medical Necessity
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CorVel Corporation
Clinical Review Supervisor
1 day ago

CorVel Corporation - Insurance - Large

Remote from
Texas (USA)
Full time

Senior (5-10 years)

ICD 503
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UAMS - University of Arkansas for Medical Sciences
Certified Procedural Coding Spec - Surg
Today

UAMS - University of Arkansas for Medical Sciences

New
Remote from
United States
Full time

Mid-level (2-5 years)

ICD Coding (ICD-9/ICD-10)
Medical Coding
CPT Coding
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AdventHealth Central Florida
Emergency Department Coder
Today

AdventHealth Central Florida

New
Remote from
United States
Full time

Mid-level (2-5 years)

Acute Care Coding
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Guide Health
Utilization Management Registered Nurse
1 day ago

Guide Health

Remote from
Illinois (USA)
Full time
Care Coordination
Utilization Management
Regulatory Compliance
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The Ohio State University Wexner Medical Center
Outpatient Medical Coder 2
Today

The Ohio State University Wexner Medical Center

New
Remote from
United States
Full time
Outpatient Coding
ICD 503
CPT Coding
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Humana
Utilization Management Behavioral Health Registered Nurse
1 day ago

Humana - Health, Sport, Wellness & Fitness - XLarge

Remote from
Alabama (USA), Arizona (USA), Arkansas (USA) +12
Part time

Mid-level (2-5 years)

Nurse Registry
Medical Necessity
Utilization Management
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Blue Cross NC
Episodic Care Manager
1 day ago

Blue Cross NC - Insurance - XLarge

Remote from
North Carolina (USA)
Full time

Senior (5-10 years)

Care Coordination
Utilization Management
Medical Necessity
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Humana
Preauthorization Registered Nurse
1 day ago

Humana - Health, Sport, Wellness & Fitness - XLarge

Remote from
Alabama (USA), Arizona (USA), Arkansas (USA) +12
Part time

Mid-level (2-5 years)

Clinical Assessments
Medical Guideline
Prior Authorization
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St. Charles Health System
PB HIM Coding Specialist 2
3 days ago

St. Charles Health System - Large

Remote from
Oregon (USA)
Full time
ICD Coding (ICD-9/ICD-10)
Healthcare Common Procedure Coding Systems
CPT Coding
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Impresiv Health
Inpatient Care Manager, RN
4 days ago

Impresiv Health - SME

Remote from
Canada, California (USA)
Freelance

Mid-level (2-5 years)

Care Coordination
Utilization Management
Discharge Planning
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Centene Corporation
Remote Medical Director, Outpatient
4 days ago

Centene Corporation - XLarge

Remote from
Arizona (USA)
Full time

Expert & Leadership (>10 years)

Utilization Management
Medical Necessity
Clinical Quality Management
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Sanford Health
Utilization Management Specialist (Home-Based) - Prior Authorization
3 days ago

Sanford Health - Large

Remote from
North Dakota (USA)
Full time
Utilization Management
Prior Authorization
Medical Necessity
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St. Charles Health System
Insurance Follow-Up Specialist
4 days ago

St. Charles Health System - Large

Remote from
Oregon (USA)
Full time
Medical Billing
Epic EMR
Insurance Follow-Up
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Sanford Health
Senior Appeal and Denial Specialist
3 days ago

Sanford Health - Large

Remote from
South Dakota (USA)
Full time

Senior (5-10 years)

Appeals
Medical Record Management
Prior Authorization
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CorVel Corporation
Medical Case Manager II
5 days ago

CorVel Corporation - Insurance - Large

Remote from
Nevada (USA)
Full time

Mid-level (2-5 years)

Discharge Planning
Case Management Systems
Evaluation Of Care
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Centene Corporation
Clinical Review Nurse - Concurrent Review
6 days ago

Centene Corporation - XLarge

Remote from
North Carolina (USA)
Full time

Mid-level (2-5 years)

Discharge Planning
Medical Necessity
Clinical Assessments
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Guide Health
Utilization Management Registered Nurse
3 days ago

Guide Health

Remote from
Illinois (USA)
Full time
Care Coordination
Utilization Management
Medical Necessity
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WellSense Health Plan
Prior Authorization Medical Clinician
30+ days ago

WellSense Health Plan - SME

Remote from
Kentucky (USA), Massachusetts (USA)
Full time
68 - 98K
Utilization Management
Prior Authorization
Medical Necessity
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UST HealthProof
Utilization Review RN
7 days ago

UST HealthProof - SME

Remote from
Massachusetts (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Discharge Planning
Care Management
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The Cigna Group
Medical Principal - Gastroenterologist
2 days ago

The Cigna Group - Health Care - XLarge

Remote from
United States, Austria
Full time

Senior (5-10 years)

212 - 354K
Utilization Management
Care Management
Medical Necessity
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Brundage Group
Physician Advisor 7 on 7 off
Just posted

Brundage Group

New
Remote from
Florida (USA)
Full time

Mid-level (2-5 years)

48 - 48K
Utilization Management
Medical Necessity
Clinical Documentation
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CorVel Corporation
Telephonic Case Manager I
12 days ago

CorVel Corporation - Insurance - Large

Remote from
Florida (USA)
Full time

Mid-level (2-5 years)

Care Coordination
Care Management
Clinical Informatics
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MASC Medical Recruitment Firm
Durable Medical Equipment (DME) Coordinator
13 days ago

MASC Medical Recruitment Firm - Human Resources, Staffing & Recruiting - TPE

Remote from
California (USA)
Full time

Expert & Leadership (>10 years)

Medicare
Vendor Payments
Electronic Health Record Applications
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Med A/Rx
Insurance Specialist (Remote) - Eastern & Central Timezones
6 days ago

Med A/Rx

Remote from
Ohio (USA)
Full time

Mid-level (2-5 years)

Medical Billing
Revenue Management
Claims And Litigation Management
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Meduit | Driving Revenue Cycle Performance
Insurance Specialist (Remote)
6 days ago

Meduit | Driving Revenue Cycle Performance - Financial Services - Large

Remote from
Minnesota (USA)
Full time

Mid-level (2-5 years)

Aftercare
Billing
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MedStar Health
Outpatient Coding Specialist - Ambulatory Surgery Unit
30+ days ago

MedStar Health - XLarge

Remote from
Idaho (USA), Maryland (USA)
Full time

Junior (1-2 years)

45 - 80K
Outpatient Coding
ICD 503
CPT Coding
View Similar Jobs →
Medical Review Institute
1099 Utilization Review for Sports Medicine Physicians
18 days ago

Medical Review Institute - SME

Remote from
Florida (USA)
Freelance

Senior (5-10 years)

Family Medicine
Utilization Management
Sports Medicine
View Similar Jobs →
Neurocrine Biosciences
Regional Patient Access Manager - NP RPAM Southwest
12 days ago

Neurocrine Biosciences - Biotech: Biology + Technology - Large

Remote from
Arizona (USA), New Mexico (USA)
Full time

Senior (5-10 years)

Patient Education And Counseling
Pharmacy Operations
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Groups Recover Together
Staff Provider (APRN/PA) - FT
10 days ago

Groups Recover Together

Remote from
Pennsylvania (USA), Tennessee (USA)
Full time

Senior (5-10 years)

Performance Analytics
Buprenorphine
Drug Regulatory Affairs
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Boomerang Healthcare
AR Specialist
30+ days ago

Boomerang Healthcare

Remote from
United States, Canada, Arkansas (USA) +1
Full time

Mid-level (2-5 years)

42 - 55K
Appeals
Accounts Receivable
Workers' Compensation Claims
View Similar Jobs →
Commonwealth Care Alliance
Remote - Registered Nurse (RN) Clinical Care Reviewer - Massachusetts only - Direct UM experience strongly preferred! - R11600
14 days ago

Commonwealth Care Alliance - Health Care - Large

Remote from
Massachusetts (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Milliman Care Guidelines (MCG)
Discharge Planning
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Martin's Point Health Care
Health Plan Data and Medical Policy Clinician (Registered Nurse/RN) - Remote
13 days ago

Martin's Point Health Care - SME

Remote from
Maine (USA)
Full time

Senior (5-10 years)

ICD 503
Cppunit
Health Policy Development
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UPMC
Coder II, Profee
7 days ago

UPMC - XLarge

Remote from
Pennsylvania (USA)
Full time

Mid-level (2-5 years)

ICD Coding (ICD-9/ICD-10)
CPT Coding
View Similar Jobs →
Point32Health
Clinical Reviewer, BH outpatient services
14 days ago

Point32Health - Insurance - Large

Remote from
Massachusetts (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Mental Health Assessments
Prior Authorization
View Similar Jobs →
Conifer Health Solutions
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
30+ days ago

Conifer Health Solutions - XLarge

Remote from
Texas (USA)
Full time
Appeals
InterQual Criteria
Medical Necessity
View Similar Jobs →
Martin's Point Health Care
Utilization Review and Appeals Nurse - Remote
4 days ago

Martin's Point Health Care - SME

Remote from
Maine (USA)
Full time

Mid-level (2-5 years)

Utilization Management
Clinical Documentation
Medical Necessity
View Similar Jobs →
Healthfirst
Appeals and Grievances Clinical Specialist
28 days ago

Healthfirst - Large

Remote from
Alabama (USA), Arizona (USA), Colorado (USA) +12
Full time
73 - 120K
Appeals
Utilization Management
Clinical Investigations
Northwestern Medicine
Patient Access Specialist, Full-time, Days (Remote - Must reside in IL, IN, IA, or WI)
5 days ago

Northwestern Medicine - XLarge

Remote from
Illinois (USA), Indiana (USA), Iowa (USA) +2
Full time

Mid-level (2-5 years)

Electronic Health Record Applications
Patient Registration
View Similar Jobs →
Dane Street, LLC
Physician Reviewer - Orthopedic Surgery (Utilization Review) TX
30+ days ago

Dane Street, LLC - Insurance - SME

Remote from
Texas (USA)
Fixed term
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Dane Street, LLC
Board Certified Internal Medicine/Pain Management Physician Advisor,
30+ days ago

Dane Street, LLC - Insurance - SME

Remote from
California (USA)
Freelance
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PRIA Healthcare
Patient Access Specialist
7 days ago

PRIA Healthcare

Remote from
Nevada (USA)
Full time

Mid-level (2-5 years)

Medical Necessity
Benefits Administration
Prior Authorization
View Similar Jobs →
US Tech Solutions
Clinical Reviewer RN
30+ days ago

US Tech Solutions - Human Resources, Staffing & Recruiting - Large

Remote from
Massachusetts (USA)
Fixed term

Mid-level (2-5 years)

InterQual Criteria
Inpatient Care
Medical Necessity
View Similar Jobs →
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