Remote RN Medical Reviewer (Temporary)

Santa Barbara Cottage Hospital; United States; Remote; USD 85,000 - 105,000; Part time

Job summary

J29, Inc. is seeking a Remote Medical Reviewer (RN) for a temporary assignment to audit Medicare FFS claims, including Part A/B, DMEPOS, and Home Health/Hospice as needed.

You will apply CMS rules, document findings, and ensure accuracy in each review while maintaining security and privacy standards. The role requires an active RN license, 5+ years in medical coding or billing, and remote work experience with diverse systems.

Qualifications

• 5+ years direct medical coding or billing in healthcare.
• 3+ years in productivity-based claims or case work outside a queued system.
• 3+ years remote work with various technology systems, Medicare FFS experience preferred.
• Active Medical Coding Certification (CPC, CCS or equivalent).
• Experience with low-code/no-code case management systems is preferred but not required.

Responsibilities

• Perform automated and complex reviews of Medicare FFS claims to assess overpayments, underpayments, and proper payments.
• Apply CMS policies and guidelines and document findings for each claim.
• Support dispute resolution with documentation and audits; ensure quality assurance.
• Collaborate with key personnel to ensure accuracy and ongoing process improvements.

Skills

Medical coding

Medical billing

Remote work experience

Medicare FFS experience

Low-code/no-code systems

Education

Registered Nurse license

Tools

Case management systems

Job description

J29, Inc. is seeking a Remote Medical Reviewer (RN) for a temporary assignment to audit Medicare FFS claims, including Part A/B, DMEPOS, and Home Health/Hospice as needed.

You will apply CMS rules, document findings, and ensure accuracy in each review while maintaining security and privacy standards. The role requires an active RN license, 5+ years in medical coding or billing, and remote work experience with diverse systems.