Remote Claims Review Nurse — Appeals & Denials Expert
Remote / Online - Candidates ideally in
San Diego, San Diego County, California, 92189, USA
Listed on 2026-07-30
San Diego, San Diego County, California, 92189, USA
Listing for:
RXinsider LTD.
Remote/Work from Home
position Listed on 2026-07-30
Job specializations:
-
Nursing
RN Nurse, Nurse Practitioner, Nurse Educator, Healthcare Nursing
Job Description & How to Apply Below
Optum is seeking a Remote RN Review Nurse to perform clinical reviews of appeals and provider disputes from anywhere in the United States. The role requires a California RN license, 1+ year UM/QI or acute/ambulatory care experience, and strong knowledge of Medicare and related guidelines.
Responsibilities include reviewing medical necessity, documenting denial reasons, and coordinating with physicians and health plans to ensure compliant resolutions.
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