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Remote Cortex Rn Jobs in Boca Raton, FL (NOW HIRING)

Seaside Home Health

Clinical Manager

Delray Beach, FL · Remote

The Part-Time QA Nurse is a remote-based RN who plays a critical role in ensuring the clinical documentation integrity, regulatory compliance, and accreditation readiness of our Florida-based home ...

ClinDCast LLC

EMR Systems Analyst

Delray Beach, FL · Remote

Preferred: * Clinical certification (e.g., RN, LPN, PT) or background in nursing or allied health. * Experience working with IT support tools (ticketing systems, remote support platforms)

Scribe-X

Remote Medical Scribe

Fort Lauderdale, FL · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...

Tempus

Senior Data Modeler I

Boca Raton, FL · On-site +1

$90K - $130K/yr

Clinical background (MD/DO, PharmD, PA, NP, RN, etc.). * Familiarity with next-generation ... Additionally, for remote roles open to individuals in unincorporated Los Angeles - including remote ...

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Remote Cortex Rn information

What are the key skills and qualifications needed to thrive as a Remote Cortex RN, and why are they important?

To thrive as a Remote Cortex RN, you need a valid RN license, strong clinical judgment, and proficiency in remote patient monitoring and telehealth practices. Familiarity with telemedicine platforms, electronic health records (EHRs), and secure communication systems is crucial. Exceptional communication, critical thinking, and the ability to work independently are important soft skills in this role. These competencies ensure effective remote care, patient safety, and smooth collaboration with healthcare teams despite the physical distance.

What are some common challenges Remote Cortex RNs face while providing patient care from a distance?

Remote Cortex RNs often navigate challenges such as building trust with patients without face-to-face interaction, ensuring clear communication through digital platforms, and adapting clinical assessments to virtual formats. They must stay organized and proactive in following up on patient needs, as well as collaborate closely with physicians and interdisciplinary teams remotely. Staying updated on telehealth best practices and technology can help overcome these hurdles and ensure high-quality patient care.

What is a Remote Cortex RN?

A Remote Cortex RN is a registered nurse who works remotely to monitor and manage patient data using the Cortex platform or similar remote patient monitoring technologies. These nurses assess patient information, provide virtual consultations, and coordinate care from a distance, allowing for continuous patient support without the need for in-person visits. This role requires strong clinical knowledge, technological proficiency, and excellent communication skills to ensure high-quality patient care in a virtual environment.

How much does Cortex pay nurses?

Cortex RNs typically earn an hourly rate that ranges from $30 to $50, depending on experience, location, and shift. Compensation may also include benefits such as health insurance and paid time off, with remote nursing roles often offering flexible schedules.

What is the difference between Remote Cortex Rn vs Remote Medical Assistant?

AspectRemote Cortex RnRemote Medical Assistant
CredentialsRegistered Nurse (RN) licenseCertified Medical Assistant (CMA) or similar certification
Work EnvironmentTelehealth, hospitals, clinicsTelehealth, clinics, outpatient settings
Job ResponsibilitiesPatient assessments, care planning, medication managementScheduling, patient intake, basic clinical support
Industry UsageHealthcare, telemedicineHealthcare, outpatient services

Remote Cortex Rn and Remote Medical Assistant roles both operate in healthcare settings, often remotely, but RNs require licensure and handle clinical patient care, while Medical Assistants focus on administrative and basic clinical tasks. Understanding these differences helps job seekers find roles aligned with their credentials and career goals.

What are the most commonly searched types of Cortex Rn jobs in Boca Raton, FL? The most popular types of Cortex Rn jobs in Boca Raton, FL are:
What are popular job titles related to Remote Cortex Rn jobs in Boca Raton, FL? For Remote Cortex Rn jobs in Boca Raton, FL, the most frequently searched job titles are:
What job categories do people searching Remote Cortex Rn jobs in Boca Raton, FL look for? The top searched job categories for Remote Cortex Rn jobs in Boca Raton, FL are:
What cities near Boca Raton, FL are hiring for Remote Cortex Rn jobs? Cities near Boca Raton, FL with the most Remote Cortex Rn job openings:
Remote Cortex Rn jobs near you
Manager, Clinical Appeals

Manager, Clinical Appeals

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Posted 20 days ago

Job description

Job Summary:

We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers. This role is responsible for overseeing day-to-day activities of clinical appeal specialists, managing appeal strategy execution, ensuring quality and compliance, and meeting client-specific performance goals.

The ideal candidate brings a strong background in clinical review, medical necessity denials, payer appeal processes, and team leadership—ideally across both U.S. and offshore teams (e.g., Philippines). This position is critical to ensuring timely and effective resolution of denied claims, supporting revenue recovery efforts, and maintaining payer and regulatory compliance.

Key Responsibilities:

  • Manage the full-cycle clinical appeals process across multiple payer types, with a focus on government (e.g., Medicare, Medicaid) and commercial payers.
  • Lead and support a team of nurses, clinical reviewers, and appeal specialists—including potential offshore (Philippines-based) staff.
  • Monitor appeal workloads, productivity, and turnaround times to ensure all appeal deadlines and client service level agreements (SLAs) are met.
  • Review and approve complex or high-value clinical appeal cases, ensuring clinical accuracy and compliance with payer guidelines.
  • Maintain up-to-date knowledge of medical necessity criteria, payer policies, NCDs/LCDs, and applicable CMS regulations.
  • Train new and existing team members on clinical guidelines, appeal writing standards, and regulatory requirements.
  • Work cross-functionally with audit, legal, compliance, and operations teams to align on strategy and escalate trends or systemic payer issues.
  • Identify and implement process improvements to increase efficiency, reduce denials, and improve overturn rates.
  • Support the creation and refinement of appeal templates, clinical arguments, and documentation standards.
  • Generate and deliver performance and quality reports to leadership, identifying risks and opportunities for improvement.

Qualifications:

  • Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health Administration, or related field preferred.
  • 5+ years of experience in clinical appeals, utilization review, or medical necessity denials.
  • 2+ years in a leadership or supervisory role, preferably within a revenue cycle or payer appeals setting.
  • In-depth understanding of payer denial processes, especially Medicare Advantage, Medicaid Managed Care, and commercial plans.
  • Experience managing remote and/or offshore teams (Philippines experience preferred).
  • Strong working knowledge of ICD-10, CPT, and HCPCS coding as they relate to clinical justifications.
  • Excellent writing skills and the ability to clearly communicate complex clinical reasoning.
  • Familiarity with appeal submission portals, EHRs, and workflow platforms.
  • Knowledge of HIPAA, CMS, and NCQA standards.

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