Medical Review Nurse, Clinical Appeals Auditor

Machinify · Other

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Full TimePosted Sep 10, 2026

Source: machinifyinc

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Specific countries

Limited to: United States — no hybrid days in this listing.

Not open from Hungary

This role’s source listing does not include Hungary as an eligible location.

Category
Other
Employment type
Full Time
Experience level
Not specified
Original employer: MachinifySource ATS: machinifyincJob status: Active

Machinify is seeking a Registered Nurse for a remote US-based role to conduct clinical appeals audits and quality assurance reviews.

The Clinical Appeals Auditor will be responsible for reviewing medical audit findings, analyzing claims data, and providing subject matter expertise on coverage rules and regulations. This role involves documenting appeal results, identifying training opportunities, and collaborating with cross-functional teams to improve audit accuracy and efficiency.

Why You’ll Love This Role

Remote - US location
Full time employment
Healthcare intelligence focus
Subject matter expert role
Focus on clinical appeals and medical audit reviews

What You’ll Bring

Registered Nurse (RN) license
Specific MDS experience
Ability to perform claim payment audits with high quality and production results
Familiarity with interpreting electronic medical records (EHR)
Proficiency in CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding
Knowledge of CMS, Medicaid and/or Commercial insurance programs

What You’ll Get

Benefits not specified in the listing

About the Company

Machinify is a healthcare intelligence company that delivers an AI-powered platform to health plans across the United States. They specialize in optimizing financial outcomes and reducing healthcare costs for over 85 health plan clients.

Listing checked for remote eligibility · Posted Sep 10, 2026 · machinifyincApply
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