Utilization Review RN
New York, NY · Remote
Additional Info: *possible remote opportunity after training if candidate demonstrates understanding of processes and policy expectations* Qualifications * Must have clear and active RN license in ...
New York, NY · Remote
Additional Info: *possible remote opportunity after training if candidate demonstrates understanding of processes and policy expectations* Qualifications * Must have clear and active RN license in ...
New York, NY · Remote
Additional Info: *possible remote opportunity after training if candidate demonstrates understanding of processes and policy expectations* Qualifications * Must have clear and active RN license in ...
Compact (NLC) license and/or California RN license required, depending on assignment Physical Demand & Work Environment * Fully remote/home-based role * Private, quiet, and secure home office free ...
Compact (NLC) license and/or California RN license required, depending on assignment Physical Demand & Work Environment * Fully remote/home-based role * Private, quiet, and secure home office free ...
Staten Island, NY · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
Staten Island, NY · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
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New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
Wayne, NJ · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
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Wayne, NJ · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
Manhattan, NY · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
Manhattan, NY · Remote
$29.05 - $67.97/hr
... auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in ...
New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
Quick apply
New York, NY · On-site +1
Remote or Hybrid, NYC Office (Manhattan - Near Bryant Park) Application Window: June, 2026 ... Valid Certified Registered Nurse Practitioner (CRNP) / Advanced Practice Registered Nurse (APRN) * ...
Partner with RNs, Community Health Workers, and clinical leadership to close care gaps and ensure ... Fully remote work environment Pair Team is an Equal Opportunity Employer. At Pair Team, we value ...
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Partner with RNs, Community Health Workers, and clinical leadership to close care gaps and ensure ... Fully remote work environment Pair Team is an Equal Opportunity Employer. At Pair Team, we value ...
Manhattan, NY · On-site +1
Registered nurse licensed to practice in New York with current New York registration and in good standing. Record of prior stable employment and/or favorable references. PREFERRED QUALIFICATIONS
Manhattan, NY · On-site +1
Registered nurse licensed to practice in New York with current New York registration and in good standing. Record of prior stable employment and/or favorable references. PREFERRED QUALIFICATIONS
New Brunswick, NJ · Remote
Current licensure as a Certified Registered Nurse Practitioner (CRNP) or Advanced Practice ... Remote-first -- work from home anywhere in the US * Growth: Advanced training by GI-specialized ...
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New Brunswick, NJ · Remote
Current licensure as a Certified Registered Nurse Practitioner (CRNP) or Advanced Practice ... Remote-first -- work from home anywhere in the US * Growth: Advanced training by GI-specialized ...
New York, NY · Remote
$26 - $33/hr
Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe ... The MA/LPN/RN plays a vital role in educating patients on how to manage their acute or chronic ...
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New York, NY · Remote
$26 - $33/hr
Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe ... The MA/LPN/RN plays a vital role in educating patients on how to manage their acute or chronic ...
At AMC Health, we are transforming healthcare through advanced remote patient monitoring and ... Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams ...
At AMC Health, we are transforming healthcare through advanced remote patient monitoring and ... Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams ...
Manhattan, NY · Remote
$28.75 - $38/hr
Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe ... The MA/LPN/RN plays a vital role in educating patients on how to manage their acute or chronic ...
Manhattan, NY · Remote
$28.75 - $38/hr
Our next-generation Remote Patient Monitoring (RPM) program enables medical teams to provide safe ... The MA/LPN/RN plays a vital role in educating patients on how to manage their acute or chronic ...
New York, NY · Remote
$29.75 - $34/hr
This role is fully remote with a flexible schedule, allowing you to help shape the future of health ... auditing * Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or ...
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New York, NY · Remote
$29.75 - $34/hr
This role is fully remote with a flexible schedule, allowing you to help shape the future of health ... auditing * Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or ...
Jersey City, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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Jersey City, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Be Seen First
Newark, NJ · Remote
$38 - $40/hr
Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short orientation, must have valid NJ RN License Job Summary: This position is responsible for performing RN duties ...
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Be Seen First
Newark, NJ · Remote
$38 - $40/hr
Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short orientation, must have valid NJ RN License Job Summary: This position is responsible for performing RN duties ...
Newark, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
Newark, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Paterson, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
Paterson, NJ · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
New York, NY · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
New York, NY · Remote
$40 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
$20.10 - $22.60
6% of jobs
$22.60 - $25.09
6% of jobs
$25.09 - $27.59
3% of jobs
$29.19 is the 25th percentile. Wages below this are outliers.
$27.59 - $30.09
15% of jobs
$30.09 - $32.58
17% of jobs
The median wage is $32.92 / hr.
$32.58 - $35.08
23% of jobs
$35.97 is the 75th percentile. Wages above this are outliers.
$35.08 - $37.57
15% of jobs
$37.57 - $40.07
8% of jobs
$40.07 - $42.57
0% of jobs
$42.57 - $45.06
0% of jobs
$45.06 - $47.56
7% of jobs
$20
$33
$47
| Aspect | Remote Rn Auditor | Remote Rn Reviewer |
|---|---|---|
| Certifications | RN license, auditing certifications (e.g., CHAP, RAC) | RN license, clinical review certifications |
| Work Environment | Healthcare organizations, insurance companies, auditing firms | Healthcare providers, insurance companies, utilization review |
| Primary Responsibilities | Auditing medical records for compliance, coding accuracy, and billing | Reviewing medical records for appropriateness and medical necessity |
Remote Rn Auditors focus on compliance and coding accuracy through audits, while Remote Rn Reviewers primarily assess medical necessity and appropriateness of care. Both roles require RN licensure and related certifications, often working within healthcare or insurance settings. The key difference lies in their core functions: auditing versus clinical review, though both contribute to quality and compliance in healthcare reimbursement.
As a remote RN auditor, your job is to review claims and audit financial statements to ensure validity and accuracy. In this role, you may examine documentation from the patient or clinic, evaluate the effectiveness of care, or ensure that claims comply with government regulations. RN auditors often provide advice for cutting costs and contact both healthcare providers and clients to negotiate specific claims or resolve billing issues. Remote RN auditors often work with daily or weekly batches of work as assigned, but in rare cases, you may be asked to prioritize auditing certain material when time is of the essence.
Full-time
Medical, Dental, Vision, Life
Posted 16 days ago
One of the largest health benefits companies in the United States. Through its networks nationwide, the company delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts.Â
Headquartered in Indianapolis, Indiana, WellPoint, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states through UniCare.
This role is specific to the LTSS department. RN will be responsible for providing case management services and evaluating the necessity/appropriateness/efficiency of the use of Medical Services for Long-Term Support Services (LTSS).
Will be responsible for collaborating with providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. May also manage appeals for services denied. Provides plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are assessed and met based on information.
Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
MAJOR JOB DUTIES AND RESPONSIBILITIES
Additional Info:
*possible remote opportunity after training if candidate demonstrates understanding of processes and policy expectations*
Advantages of this Opportunity:
Competitive salary, negotiable based on relevant experience
Benefits offered, Medical, Dental, and Vision
Fun and positive work environment
Monday through Friday 8am-5pm
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003