Job Title: Medical Claims Review Nurse

Duration: 6 Months

Location: Remote

Payrate: $43.39/hr. on W2



Description

100% Remote (CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 17 STATES (SC, MS, AZ, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside greater-NYC), OH, SC, TX, UT, WA (outside greater-Seattle), WI)



Working hours: Per HM, 40 hours but flexible and will be discussed during interview. No weekends or holidays.



Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the patient’s documented clinical condition, services rendered, and billed charges.

Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity.

Identifies inconsistencies that impact reimbursement such as unsupported diagno...