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From Home Claim Reviewer Jobs (NOW HIRING)

Amentum

Senior Paralegal

Washington, DC · On-site

Populates claim review worksheets and claim summary templates, including incorporating data from the initial checks completed in pre-screen. * Administrative Checks: Performs administrative checks ...

Pae

Senior Paralegal

Washington, DC · On-site

$31.69/hr

Populates claim review worksheets and claim summary templates, including incorporating data from the initial checks completed in pre-screen. * Administrative Checks: Performs administrative checks ...

033 Palmetto GBA

Medical Reviewer

Columbia, SC · Remote

... working from home must maintain a private, quiet workspace and have reliable high-speed internet ... What You'll Do Perform medical claim reviews for one or more of the following: claims for medically ...

033 Palmetto GBA

Medical Reviewer

Columbia, SC · Remote

... working from home must maintain a private, quiet workspace and have reliable high-speed internet ... What You'll Do Perform medical claim reviews for one or more of the following: claims for medically ...

Pae

Senior Paralegal

Washington, DC · On-site

Populates claim review worksheets and claim summary templates, including incorporating data from the initial checks completed in pre-screen. * Administrative Checks: Performs administrative checks ...

Amentum

Senior Paralegal

Washington, DC · On-site

$31.69/hr

Populates claim review worksheets and claim summary templates, including incorporating data from the initial checks completed in pre-screen. * Administrative Checks: Performs administrative checks ...

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Infographic showing various From Home Claim Reviewer job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 72% Full Time, 22% Part Time, and 4% Contract. Highlights an 80% Physical, 1% Hybrid, and 19% Remote job distribution.

Hospice Physician Audit Reviewer (Remote)

VITAS Healthcare

Miramar, FL • On-site

Full-time

Posted 16 days ago

VITAS Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 115 frontline employees who took The Breakroom Quiz

34th of 247 rated social care providers

Job description

Hospice Physician Audit Reviewer will have experience supporting external government record requests by preparing chart summaries and expert testimony at administrative hearings as needed. In addition, although this position's responsibilities will usually be conducted from their home office, this role is also involved in travel to provider locations to provide in-person trainings and partner with program support initiatives as needed. Work remote.  
Experience:

  • The medical review physician should review the documentation submitted and identify the following content that support's the patient's appropriateness, including any higher level of care billed, if applicable: clinical history and physical findings, documentation of functional status and symptoms, and pertinent changes in plans of care.
  • The medical review physician should review certification / recertification worksheets and narratives, plans of care review, and interdisciplinary team notes to ensure that they collectively reflect and support the patient's hospice benefit appropriateness. Where there are inconsistencies or omissions, the physician should provide explanation or suggest correction.  
  • The medical review physician should prepare a summary (demographics, time of admission, course of care under review, disposition, statement of eligibility) outlining the patient's hospice benefit appropriateness and focus on bringing the claim reviewer's attention to the specific documentation that supports the patient's hospice eligibility, as well as any additional supportive documentation that may be added at the time of the appeal. Where appropriate, the medical review physician should reference evidence based guidelines or journal articles. 
  • If a detailed claim denial explanation was provided in the claim review summary, the medical review physician should: 1. Verify whether the claim denial code is legitimate for the level of care on date(s) in contention, 2. Identify if there are discrepancies between the claim review explanation and supporting documentation, 3. Address each claim denial reason with the necessary explanation and supportive documentation, 4. Identify whether there are additional chart documents not included in the first submission that establish hospice appropriateness. 
  • The chart review note submitted by medical review physician in preparation for submission of appeal, should summarize findings recorded elsewhere in the record and not conflict with daily progress notes. New information should be supported by additional documentation that has been accessed from the chart. 
  • Performs related duties as required. This position description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Education: 

  • Board eligible / certified in Hospice and Palliative Medicine, Family Medicine, Internal Medicine, or other related specialty with a working knowledge of the principles of palliative medicine and symptom management.
  • Completion of designated application and verification of credentials and qualifications.

Certification & Licensure:

  • Licensed to practice medicine or osteopathy in the state in which the program is operating.

Physical Requirements:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

SPECIAL INSTRUCTIONS TO CANDIDATES

  • EOE/AA M/F/D/V

What VITAS Healthcare employees say

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About VITAS Healthcare

Sourced by ZipRecruiter

VITAS Healthcare, located in Miami, FL, US, is a pioneer in the American healthcare industry, specifically within the realm of hospice care and palliative services. The company began its operations in 1978 under the visionaries Hugh Westbrook and Esther Colliflower,both social workers, who identified the need for compassionate end-of-life care. Recognizing the dire need to fill the void in hospice care, they established VITAS Healthcare with the mission to provide patients experiencing end-of-life stages with high-quality care, demonstrating respect for every individual's decisions and maintaining a supportive environment for both the patients and their loved ones. A noteworthy achievement of VITAS is that it was the first organization to have its hospice program licensed in Florida prompting a nationwide shift in the way end-of-life care services were handled.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US

Year founded

1978

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