Explore 71 Remote Medical Necessity Jobs
Join a national managed care organization as a Senior Clinical Coding Auditor & Trainer, focusing on improving coding accuracy and compliance.
The Health Services Professional develops clinical policies and supports inquiries regarding medical necessity at CVS Health.
C.R
Capital Rx
The Appeals Pharmacist is responsible for reviewing clinical coverage determinations and appeals to ensure quality decision-making.
B.V
Broadway Ventures
Join Broadway Ventures as a Remote Registered Nurse to conduct medical claims reviews ensuring compliance and reimbursement eligibility.
The Clinical Appeals Specialist RN is responsible for reviewing and appealing clinical claim denials and audit determinations in a healthcare setting.
The Healthcare Utilization Specialist ensures clients receive the right care through effective claims processing and collaboration within the team.
The Physician Reviewer will utilize clinical expertise to review medical records and determine medical necessity for Independent Medical Exams.
Join Northwestern Medicine as a full-time RN in the Orders Management Unit, focusing on outpatient order management and compliance.
Join as a Physician Reviewer/Advisor to conduct independent medical record reviews and provide evidence-based assessments.
Join as an Independent Medical Examiner for orthopedic surgery, providing expert reviews on medical necessity and insurance appeals.
Join SmarterDx as a Utilization Management Specialist to optimize hospital resource use and enhance patient management through clinical AI.
Seeking a Board Certified Physician Reviewer/Advisor specializing in ENT for Independent Medical Exams.
MDLive
MDLive
Join EviCore as a Medical Director for Colon & Rectal Surgery, leveraging your clinical skills to improve patient care while working remotely.
Dane Street is seeking Licensed Reviewers who are Board Certified Behavioral Analysts for telework opportunities.