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Data reviewer work from home jobs

- 124 jobs
  • Linguistic Reviewer (Remote)_

    Outlier Ai 4.2company rating

    Remote job

    Join a global community of talented professionals to shape the future of AI. Earn up to $15 USD/hr and additional rewards based on quality of submission. Outlier is committed to improving the intelligence & safety of AI models. Owned and operated by Scale AI, we've recently been featured in Forbes for partnering experts with top AI labs to provide the high quality data for LLMs. We believe AI can only perform as well as the data it's trained on. That's why we work with contributors from all over the world, who help improve AI models by providing expert human feedback. This data has led to AI advancements for the world's leading AI labs and large language model builders. We've built a best-in-class remote work platform for our freelance contributors to provide valuable, specialized skills, and we in turn strive to provide them with a positive experience based on our core pillars of reliability, transparency, and flexibility. What you will be doing We are looking for someone who speaks fluent English to contribute their expertise toward training and refining cutting-edge AI systems. Adopt a "user mindset" to produce natural data to meet the realistic needs you have or would use AI for. Use the tool of rubrics to address user needs in a structured way. Evaluate AI outputs by reviewing and ranking reasoning and problem-solving responses from large language models. Contribute across projects depending on your specific skillset and experience. What we're looking for Education: Bachelor's degree or higher (or currently enrolled). Analytical and Problem-Solving Skills: Ability to develop complex, professional-level prompts and evaluate nuanced AI reasoning. Strong Writing: Clear, concise, and engaging writing to explain decisions or critique responses. Attention to Detail: Commitment to accuracy and ability to assess technical aspects of model outputs. Nice to Haves: Experience in fields like literature, creative writing, history, philosophy, theology, etc. Prior writing or editorial experience (content strategist, technical writer, editor, etc.). Interest or background in AI, machine learning, or creative tech tools. Compensation and benefits Earn up to $15 USD/hr, paid out weekly Rates vary based on quality, accuracy, and time spent. Paid via PayPal & AirTM Free access to Model Playground Interact, experiment and engage with leading large language models free of cost Flexible schedule and time commitment No contracts, no 9-to-5. You control your schedule. (Most experts spend 5-10 hours/week, up to 40 hours working from home Join a global community of Coding experts Join a global network of experts contributing to advanced AI tools Disclaimer: For non-core work, such as during initial project onboarding or project overtime phases, lower rates may apply. Certain projects offer incentive payments. Please review the payment terms for each project. Equal Opportunity Employer: Outlier is committed to fostering a diverse and inclusive work environment. We welcome applicants from all backgrounds and celebrate diversity in our workforce.
    $15 hourly 2d ago
  • Medical Content Reviewer - Remote - Nationwide

    Vituity

    Remote job

    Remote, Nationwide - Seeking Medical Content Reviewer Everybody Has A Role To Play In Accelerating Healthcare Innovation If you want to be part of changing healthcare to better serve patients, you are in the right place. With Inflect Health you will join a team of individuals dedicated to optimizing healthcare for all. Join the Inflect Health Team. At Inflect Health, Vituity's Innovation Hub, we identify, develop, and invest in leading-edge technologies and solutions that strengthen Vituity's history of healthcare transformation. When you join our team, you are part of a community that is committed to sharing the future of healthcare by prioritizing the human element in innovation - focusing on the provider and patient outcomes, not just the technology. The Opportunity * Craft expert responses, showcasing your deep knowledge of medical principles to enhance machine learning of healthcare data. * Analyze samples based on provided information, demonstrating your ability to apply your expertise effectively. * Evaluate samples in sequential descending priority in a multi-step project, which will be used as inputs for a model. Required Experience and Competencies * Resume and cover letter required upon applying. * Eligibility to work in the U.S. * Expertise and experience in healthcare. * Experience using G-Suite (e.g. Google Sheets, etc.). * English language proficiency. We are excited to share the base salary range for this position is $60.00, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company's annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details. Innovation and transformation are required to navigate and improve the evolving landscape of healthcare, and we believe everyone can play a role in that. We strive to be a catalyst for that transformation through improvement in healthcare delivery and the development of health technologies. If you want to make a difference, Inflect Health is the place to do it. Inflect Health does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Inflect Health is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity. Applicants only. No agencies please.
    $60 hourly 60d+ ago
  • Seasonal Tax Reviewer (Full Time)

    1-800Accountant

    Remote job

    Job Title: Seasonal Tax Reviewer (Remote) Job Type: Seasonal/Temporary Hours Expected: 9:00 AM- 6:00 PM PST Monday through Friday with the possibility of weekend hours. 40 hours and 55. Compensation: $35-$45/ hour $2800 to $3600 Bi-weekly, exempt role Duration: December 15th, 2025 through April 30th, 2026 Location: Fully Remote Who We Are: At 1-800Accountant, we believe in using business as a force for good. We are defining a new accounting services model to help business owners navigate the new economy. We combine technology with a dedicated accountant to serve the needs of start-ups, entrepreneurs, and small businesses by providing extraordinary service at an affordable price. Our team helps business owners focus on their passion for their business while helping them with their finances, creating a collaborative effort to help their business thrive. Position Overview: We are seeking an experienced and detail-oriented Seasonal Tax Reviewer to join our team. In this role, you will be responsible for reviewing personal and small business tax returns prepared by our tax preparers, ensuring accuracy, compliance, and quality. This is a remote position, perfect for individuals with a strong background in tax review and a commitment to delivering high-quality service to clients. The ideal candidate will have a keen eye for detail, a deep understanding of tax regulations, and experience working in a fast-paced, deadline-driven environment. Key Responsibilities: * Review individual (1040) and small business tax returns (such as S-Corp, C-Corp, Partnerships, and LLCs) prepared by tax preparers to ensure completeness, accuracy, and compliance with tax regulations. * Verify all tax forms and calculations, ensuring all tax positions are supported with adequate documentation and adhere to federal, state, and local tax regulations. * Provide constructive feedback to tax preparers to address discrepancies or errors and ensure corrections are made in a timely manner. * Collaborate with tax preparers to provide guidance on complex tax issues and help them improve their understanding of tax regulations and preparation processes. * Communicate with clients to gather additional information, clarify discrepancies, and resolve tax issues as needed. * Reviewing bookkeeping and payroll as needed. * Ensure timely review and filing of tax returns, adhering to deadlines and client expectations. * Stay up-to-date with changes in tax laws and regulations and communicate relevant updates to the team. * Provide exceptional customer service, maintaining a high level of professionalism and client satisfaction. Qualifications: * Bachelors degree in Accounting, Finance, or a related field; CPA, EA, or equivalent certification required. Must have a valid PTIN. * 3+ years of experience in tax preparation and review, with a strong focus on individual and small business returns. * In-depth knowledge of federal, state, and local tax laws and regulations. * Proficiency with tax preparation software (Lacerte preferred) * Ability to work in a paperless environment utilizing multiple software applications. * Excellent attention to detail and strong analytical skills to identify errors and discrepancies. * Strong communication skills, both written and verbal, with the ability to explain tax concepts clearly to clients and team members. * Ability to work independently in a remote setting and manage multiple tasks and deadlines efficiently. * High level of integrity and professional ethics in handling confidential client information. * Flexibility to work additional hours during peak tax season as needed. Computer Requirements: * PROCESSOR * Windows: Intel Core i5 (6th gen+) OR AMD Ryzen (5th gen+) * Mac: Apple M1 or newer OR Intel Core i5 (6th gen+) * MEMORY (RAM) * Minimum 8 GB * HARD DRIVE TYPE * Must be SSD (Solid State Drive) - HDD not supported * STORAGE * At least 128 GB capacity with 1 GB available space * OPERATING SYSTEM * Windows: Windows 10 (22H2, 64-bit) OR Windows 11 (22H2/23H2/24H2) Mac: mac OS Ventura (13+), Sonoma (14+), or Sequoia (15+) Benefits: * Holiday Pay (Christmas, New Years Day) * Sick Pay (24 hours) * Work with the countrys largest virtual accounting firm * Work with cutting-edge technology Diversity 1-800Accountant is an equal opportunity employer and makes employment decisions on the basis of merit. 1-800Accountants policy prohibits unlawful discrimination based on race, color, religious creed, sex, gender identity, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), sexual orientation, pregnancy, or any other consideration made unlawful by federal, state, or local laws. It also prohibits discrimination based on a perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics. All such discrimination is unlawful. #TaxAdvisory1
    $35-45 hourly 16d ago
  • DRG (Coding) Reviewer/Auditor

    Medreview

    Remote job

    At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently. Required attendance of all departmental team meetings and/or training. Work on other duties or tasks, as necessary. Performance Expectations: Report productivity daily utilizing department productivity report. Meet/exceed daily productivity expectations. Maintains 95% accuracy in claim reviews. Required to work a 7.5-hour workday within the company's core hours. Comply with organization policy and procedures. Qualifications: Coding Certification required (at least one of the following is required and must be maintained as a condition of employment). Certified Coding Specialist (CCS) Certified Inpatient Coder (CIC) Registered Heath Information Technician (RHIT) College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses. At least 3 years' experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing. Payment integrity DRG validation is a plus. Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates. Requires working knowledge of applicable industry-based standards. Proficiency in Outlook, Word, Excel, and other applications. Excellent written and verbal communication skills. Maintain professional credentialed status with approved continuing education programs Ability to work independently and can multi-task or transition to different tasks easily. Remote Work Requirements: High speed internet (100 Mbps per person recommended) with secured WIFI. A dedicated workspace with minimal interruptions to protect PHI and HIPAA information. Must be able to sit and use a computer keyboard for extended periods of time. Benefits and perks include: Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents. 401(k) with Employer Match - Join the team and we will invest in your future Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you're not feeling well, to observe holidays. Wellness - We care about your well-being. From Commuter Benefits to FSAs we've got you covered. Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we're focused on your growth as a working professional. Salary Range: $85,000- 90,000/ annually.
    $85k-90k yearly Auto-Apply 60d+ ago
  • Disease Specific -Stroke Reviewer - Intermittent

    The Joint Commission 4.6company rating

    Remote job

    Nationwide Search-Incumbent can reside anywhere in the United States - Disease Specific Care Stroke Field representative. The Disease Specific Care Field Representative applies sophisticated analysis skills and inductive reasoning skills to determine a health care organization's degree of compliance with applicable program standards. They must be able to employ advanced and sometimes nuanced communication skills to engage health care organization staff in interactive dialogues on a broad array of health care issues to assess compliance and to identify opportunities for improving compliance. Responsibilities Conducts a thorough evaluation of assigned services and programs that meet DSC certification eligibility criteria. Plans, reviews and apportions review time so that all review requirements are addressed thoroughly per program. Reviews and evaluates pre-review information; researches, collects, organizes, and interprets a large volume of information from multiple sources. Interviews staff and patients to determine level of compliance with standards. Analyzes documents, such as performance data and clinical practice guidelines, to assess the level of compliance with The Joint Commission standards, evidence of performance improvement, and quality of care. Using established review protocols: Analyzes written self-descriptive program information. Participates in and/or conducts all required conferences and interviews; analyzes all data submitted by the organization. Documents all recommendations, providing adequate indication on non-compliance. Submits review findings in a complete, accurate, and timely manner to the Central Office. Interprets and explains the intent of the standards to the organization's personnel. Consults with staff during review re: non-compliance, opportunities for improvement, and remedial action required. Recommends publications and other resources that clarify standards and/or demonstrates compliance with standards. Qualifications Advanced Degree in Nursing or Licensure as a Physician required. Board Certification in Neurology required. You must hold a CPHQ certification (Certified Professional in Healthcare Quality) through National Association for Healthcare Quality (NAHQ) at time of hire or attain by December 31, 2028. Five years clinical experience with the care of Stroke patients required. Experience with a Joint Commission Comprehensive Stroke Center strongly preferred, however will consider those with Joint Commission Primary Stroke Center experience. All positions require 100% nationwide travel. We are currently looking for candidates who are available to work .14 FTE (3 consecutive days per month) and .48 FTE (2 weeks per month). Extensive nationwide travel required. We are currently hiring for our next orientation class to take place on February 2, 2026. Joint Commission offers a comprehensive benefits package. For an overview of our benefits package, please visit our Joint Commission Career Page This job description is intended to describe the general nature and level of work performed by an employee assigned to this position. The description is not an exhaustive list of all duties, responsibilities, knowledge, skills and abilities, and working conditions associated with this position. All requirements are subject to possible modification due to business needs and/or reasonable accommodations for individuals with disabilities. Min USD $112,000.00/year Max USD $112,000.00/year
    $112k yearly Auto-Apply 30d ago
  • Per Diem Coding & OASIS Reviewer

    Healthcare Senior Data Management Analyst/Programmer In Phoenix, Arizona

    Remote job

    BerryDunn is seeking a Per Diem Coding & OASIS Reviewer to join our Healthcare group. This position is responsible for accurate review of clinical documentation, assigning of ICD-10 codes based on coding guidelines, and review of OASIS assessment items for correct responses. Ongoing education and consulting with the client are essential to the success of this review process. This is a remote position requiring the Reviewer to work independently. Our Healthcare/Not-for-Profit Practice Group is our largest industry sector. Our Home Health and Hospice Practice Area consists of over fifty professionals providing services to Home Health and Hospice providers throughout the country. In addition to coding and OASIS consulting services, our Home Health and Hospice team services include compliance services, interim management, and operational and revenue cycle consulting services. Travel Expectations: There is no travel expecation for this position. You Will Timely and accurate review of patient records at OASIS timepoints: SOC, ROC, Recert, Transfer & Discharge. Hospice coding & HOPE assessments experience is a plus. Communicate directly with internal & agency clinical staff as needed via EMR notes, MS Teams or email. Participation in BerryDunn monthly internal or external agency meetings as needed. Maintain professional and technical knowledge, including required coding and OASIS certifications and continuing education credits by attending educational workshops and reviewing professional publications. Dedicate a minimum average of 20 hours per week or 80 hours per month work availability. Other duties as assigned. You Have Excellent communication and time management skills, including the ability to prioritize tasks and manage self remotely. Minimum of 5 years recent coding, OASIS and plan of care review experience. Knowledge of clinical coding, documentation review, medical terminology, anatomy and physiology, compliance & regulatory guidelines are required Licensure & Certification: Certification in Home Health Coding required Certification in Oasis required Clinical licensure is a plus Compensation Details The hourly rate for this role is $32.00-$37.00 per hour. This rate range represents BerryDunn's good faith and reasonable estimate of the possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final rate may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The hourly rate for the finalist selected for this role will be based on a variety of factors, including but not limited to, years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations. BerryDunn Benefits & Culture Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what's expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn. We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact ********************* to request an accommodation. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. About BerryDunn BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm's tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm. BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more at berrydunn.com. #BD_ATA Don't See A Match For You At This Time? We invite you to join our Talent Connection and let's stay in touch
    $32-37 hourly Auto-Apply 1d ago
  • Content Reviewer (Spanish)

    Tech Firefly 4.0company rating

    Remote job

    The Content Reviewer is responsible for supporting content management, data integrity, and quality assurance processes across various projects. This role involves organizing and classifying digital assets, reviewing data for accuracy, evaluating content quality for applications, and performing quality assurance checks to ensure high operational standards. MUST BE FLUENT IN SPANISH Pay: $60,000-$80,000 salary depending on location 100% Remote in the United States Long Term Contract Opportunity Key Responsibilities Review and discover new content as assigned by the Project Manager. Utilize internal management tools to classify and assign content into a product-specific content repository and database. Record and maintain all relevant information in structured spreadsheets. Review and analyze lists of data provided by the Project Manager for a variety of project purposes. Identify inconsistencies or anomalies in data and flag or resolve them as appropriate. Review videos or other data related to the application to assess content quality and identify data issues. Apply fixes within internal tools or spreadsheets, or report unresolved issues for escalation. Ensure alignment with internal content standards and data accuracy expectations. Conduct quality checks on each type of completed work across all team members to ensure compliance and consistency. Use agreed-upon quality forms and scoring methodologies to evaluate accuracy and completeness. Maintain records of QA results and communicate findings to relevant stakeholders. Requirements Bachelor's degree or equivalent experience in Content Management, Data Operations, Media Studies, or a related field. Fluent in Spanish Strong attention to detail and data accuracy. Experience working with content management systems, databases, or spreadsheets. Familiarity with video platforms preferred. Excellent organizational and analytical skills. Ability to work independently and collaboratively with cross-functional teams. Benefits Paid Time Off Paid Holidays Subsidized Medical, Dental and Vision Insurance 401k Employee Assistance Programs
    $60k-80k yearly Auto-Apply 45d ago
  • Code Reviewer, Software Assurance - Junior

    Aretum

    Remote job

    Client Suitability Required Aretum is a mission-driven organization committed to delivering innovative, technology-enabled solutions to our customers across defense, civilian, and homeland security sectors. Our teams work at the intersection of strategy, technology, and transformation, helping agencies solve their most critical challenges. We believe in investing in our people and creating a culture where collaboration, inclusion, and professional growth are at the forefront. Job Summary Aretum is seeking a highly skilled and experienced Code Reviewer, Software Assurance to perform code scan reviews and to analyze custom-developed software for security and quality flaws. The ideal candidate will bring a strong software development background, hands-on experience with code scanning tools (Fortify and CodeQL), and proven experience in working and managing large backlogs of code reviews and guiding secure development practices. This role plays a critical part in maintaining high standards of software security, compliance, and documentation across the development lifecycle. You will work closely with cross-functional customer teams including developers, program managers, security engineers, project managers, and stakeholders. Due to the nature of our work as a federal consulting organization, employees may be expected to handle Controlled Unclassified Information (CUI) and must adhere to applicable safeguarding and compliance requirements. Responsibilities Conduct detailed manual and automated code reviews to identify security, quality, and compliance issues across custom-developed applications. Interface with customers on an as needed basis to provide support, enable customer initiatives, and aid in inquiries. Perform peer reviews of Software Assurance Team members on secure code practices. Maintain and improve internal procedures and knowledgebases for secure code analysis. Utilize industry-standard tools (e.g., Fortify SCA, CodeQL, SonarQube) to perform static code analysis and interpret results. Prioritize large backlog of code review requests, ensuring timely and accurate assessments. Provide guidance to developers and security analysts on secure coding standards and remediation best practices. Collaborate with cross-functional teams including software engineers, program managers, and security teams to ensure alignment with security and quality objectives. Maintain detailed documentation of findings, associate risks, and mitigation strategies for customer-facing reports. Perform threat modeling and risk analysis to contextualize vulnerabilities and recommend mitigation steps. Stay current with emerging technologies, vulnerabilities, and industry standards (e.g., OWASP, NIST, ISO). Attend and actively participate in meetings. Continuously improve code review processes and tool effectiveness through metrics and feedback loops. Requirements Bachelor's degree in Computer Science, Software Engineering, Cybersecurity, or related field. 5+ years of professional software development experience with strong proficiency in at least two major programming languages (e.g., Java, C#, Python, JavaScript). 2+ years of hands-on code review and static analysis experience using tools such as Fortify SCA, CodeQL, or equivalent. Proven expertise in secure coding practices and application security frameworks, including OWASP Top 10, CWE/SANS, and threat modeling. Strong knowledge of SDLC, DevSecOps practices, and CI/CD integration for automated security testing. Background in cybersecurity and risk management, with the ability to evaluate business impact and risk prioritization. Experience managing high-volume code review workflows and balancing competing priorities. Excellent communication skills, with the ability to convey technical findings clearly to both technical and non-technical stakeholders. Strong analytical and problem-solving skills, with attention to detail and commitment to high-quality work. Preferred Qualifications Masters in Computer Science, Software Engineering, Cybersecurity, or related field. Travel Requirements This is a remote position; however, occasional travel may be required based on project needs, client meetings, team collaboration events, or training sessions. Travel is expected to be less than 10% and will be communicated in advance whenever possible. EEO Statement Aretum is committed to fostering a workplace rooted in excellence, integrity, and equal opportunity for all. We adhere to merit-based hiring practices, ensuring that all employment decisions are made based on qualifications, skills, and ability to perform the job, without preference or consideration of factors unrelated to job performance. As an Equal Opportunity Employer, Aretum complies with all applicable federal, state, and local employment laws. We are proud to support our nation's veterans and military families, providing career opportunities that honor their service and experience. Equal Opportunity Employer/Veterans/Disabled U.S. Work Authorization Due to federal contract requirements, only U.S. citizens are eligible for this position. This position supports a federal government contract and requires the ability to obtain and maintain a Public Trust or Suitability Determination, depending on the agency's background investigation requirements. Benefits Health Care Plan (Medical, Dental & Vision) Retirement Plan (401k) Life Insurance (Basic, Voluntary & AD&D) Paid Time Off Family Leave (Maternity, Paternity) Short Term & Long-Term Disability Training & Development
    $43k-64k yearly est. Auto-Apply 43d ago
  • Clinical Reviewer (SCA) - Remote

    Acentra Health

    Remote job

    Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer (SCA) to join our growing team. Job Summary: The purpose of this position is to utilize clinical expertise during beneficiary interaction and determine appropriateness for advocacy intervention in conjunction with contract requirements, critical thinking and utilize decision-making skills to assist with communicating determine medical appropriateness, while maintaining production goals and QA standards. Ensures day-to-day processes are conducted in accordance with NCQA and other regulatory standards. * This position is remote. Monday - Friday 11:30 AM to 8:00 PM* Responsibilities: * Assures accuracy and timeliness of all applicable review type cases within contract requirements * Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department * In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas * Maintains current knowledge base related to review processes and clinical practices related to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns * Functions as providers' liaison and contact/resource person for provider customer service issues and problem resolution * Performs all applicable review types as workload indicates * Fosters positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process * Attends training and scheduled meetings and for maintenance and use of current/updated information for review * Cross trains and perform duties of other contracts to provide a flexible workforce to meet client/customer needs * Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. Qualifications Required Qualifications * Active unrestricted LPN, RN or, Social Worker or other applicable State and/or Compact State clinical license * Minimum three years of clinical experience in an acute or med-surgical environment * Strong clinical assessment and critical thinking skills required * Medical record abstracting skills required * Excellent written and verbal communication skills * Must be proficient in Microsoft Office and Internet/web navigation Preferred Qualifications * Bachelor's Degree from an accredited college or university in a related field * Some knowledge of Case Management, UR and/or Prior Authorization or related experience * Experience in a behavioral health setting * Bilingual Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at ********************************* EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Compensation The pay range for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $27.00 - USD $33.00 /Hr.
    $27-33 hourly 10d ago
  • Enrollment Reporting Reviewer (onsite)

    Keiser University

    Remote job

    The Enrollment Reporting Reviewer works under the Associate Vice Chancellor for Student Financial Services. The key contribution of the Enrollment Reporting Reviewer is to review, amend, and return accurate enrollment rosters to the NSLDS. Responsibilities: * Reviewing student enrollment rosters provided by NSLDS monthly * Tracking and revising all files in a timely manner * Assisting with the reporting of Gainful Employment and Financial Value Transparency (GE/FVT) data * Maintaining compliance with all federal regulations and university policies & procedures ESSENTIAL FUNCTIONS: The Enrollment Reporting Reviewer must be knowledgeable in Department of Education (ED) compliance regulations and follow the NSLDS Enrollment Reporting Guide and other ED regulations. The Reviewer must use various software tools to carry out the review and analysis of the following: * Rosters forwarded to the institution each month by the NSLDS * The institutional student information system (SIS) to match the rosters received * Internal systems to review, amend and return files to the NSLDS * Error Reports provided by the NSLDS stemming from submitted rosters * Reviewer will work with Registrar, Deans and others to resolve Enrollment data conflicts * Reviewer imports/exports files via the EdConnect System * Reviewer will work online, as needed, in NSLDS and COD and other systems as needed to validate accuracy of data * Reviewer will work Gainful Employment & Financial Value Transparency reporting Knowledge, Skills, and Experience: The Enrollment Reporting Reviewer role is primarily focused on the review of data related to federal enrollment reporting in higher education. The Enrollment Reporting Reviewer works closely with other Enrollment Reporting Reviewers to review multiple files for different schools and campuses throughout the organization. Below is an inclusive, but not exhaustive, list of various knowledge, skills, and other characteristics that are necessary for effective performance as the Enrollment Reporting Reviewer. Knowledge: * Understanding of data mining and data interpretation * Familiarity with database management systems to extract, transform & load data * Understanding of file formats and best practices for uploading & downloading data Skills: * Strong verbal and written communication for collaboration and reporting findings * Strong problem-solving skills and the ability to interpret complex data sets * Proficiency in data analysis, database management tools and file transfer protocols * Managing time effectively while maintaining a high degree of data analysis accuracy Experience: * 2 years of experience in data analysis including managing data files and troubleshooting transfer issues * 2 years quality assurance to ensure data accuracy through detailed review and data validation * 2 years working collaboratively across departments and teams Education, Experience, and Training: * Associate's degree required * Bachelor's degree preferred This is an onsite position located at the Office of the Chancellor in Fort Lauderdale, FL.
    $38k-57k yearly est. 60d ago
  • Title Reviewer - Remote Work from Home!

    Aldridge Pite LLP 3.8company rating

    Remote job

    Aldridge Pite, LLP is a multi-state law firm that focuses heavily on the utilization of technology to create work flow synergies with its clients and business partners. Aldridge Pite is a full-service provider of legal services to depository and non-depository financial institutions including banks, credit unions, mortgage servicing concerns, institutional investors, private firms, and other commercial clients. Aldridge Pite is dedicated to providing best-in-class representation across all of its Practice Areas through its unwavering subscription to three fundamental tenets: Partnership, Integrity, and Innovation. Purpose Review title reports on properties referred for foreclosure and identify any defects that may exist in the chain of title to determine whether title is clear to proceed with foreclosure or if title curative work may be needed. In addition to reviewing Georgia titles, this position will also have exposure to titles from Alabama and Tennessee properties. Specific Duties, Activities and Responsibilities Analyze and summarize title abstracts and recorded documents which affect condition of title to property (e.g., security deeds, conveyancing deeds, liens, UCCs etc.) Examine any probate documents in the chain of title Review to confirm that the legal description is valid. Experience with reading long legal descriptions and familiarity with survey terms required. May need to use Deed Plotter to check descriptions for closure Be familiar with Georgia Title Standards and identify title issues/defects (Alabama and Tennessee a plus) Compare descriptions in the chain of title to determine if vesting deed is correct and if the security deed encumbers the correct property Determine conditions required to obtain clear title through a foreclosure Examine security deeds, liens, orders, easements, plats, tax maps and surveys to verify legal description, ownership, restrictions, or conformity to requirements Review and confirm assignment chain is complete Review tax searches Verify that the information in the title search and accompanying documentation is accurate and complete Analyze encumbrances to title, familiarity with title statutes and standards, and prepare report outlining exceptions and actions required to clear title Prepare documentation of review and correspondence to transmit same with requirements to clear title to Vendor and Clients Initiate and follow-up on title issue resolution with Vendors, Attorneys and Clients to resolve title issues. Work closely with the Title Curative department Completes title related steps assigned to the firm within the client systems Assist with other duties and special projects as needed Job Requirements Bachelor's Degree Four to Six years of experience with residential real estate title and title insurance. Commercial experience a plus. Background with information technology a plus Ability to manage and prioritize large caseload Knowledge of Georgia title law and procedures Knowledge of Alabama and Tennessee title law and procedures a plus Knowledge of typical electronic default services platforms preferred (e.g. LPS, Tempo, Vendorscape) Working knowledge of general title policy underwriting standards In addition to remote work for most positions, we offer a comprehensive benefit program including: Company Paid Life and Disability Insurance plans Medical, Dental and Vision Plans with Prescription coverage 401K Retirement Savings Plan Flexible scheduling (within reason, depending on position) Generous PTO plan for all full-time employees Full equipment station at no cost for remote employees, including dual monitors Employee Assistance Plan, offering free 24/7 counseling and consulting services to support emotional health and wellbeing Wellness programs and employee discounts Learning and development training opportunities for both personal and professional growth And so much more! Aldridge Pite, LLP is fully committed to Equal Employment Opportunity and to attracting, retaining, developing and promoting the most qualified employees without regard to race, gender, color, religion, sexual orientation, national origin, age, physical or mental disability, citizenship status, veteran status, or any other characteristic prohibited by federal, state or local law. We are dedicated to providing a work environment free from discrimination and harassment, and where employees are treated with respect and dignity.
    $65k-82k yearly est. Auto-Apply 60d+ ago
  • Reviewer III, Medical

    Palmetto GBA 4.5company rating

    Remote job

    Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Create and analyze reports to support operations. Ensure the correctness of analysis and report findings concisely to senior management. Directly responsible for data accuracy as financial and operational decisions are made based on the data provided. Logistics: CGS (cgsadmin.com) Location: This position is full-time (40-hours/week) Monday-Friday and can be worked remotely. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. What You'll Do: Performs medical claim reviews for one or more of the following: claims for medically complex services, services that require preauthorization/predetermination, requests for appeal or reconsideration, referrals for potential fraud and/or abuse, and correct coding for claims/operations. Makes reasonable charge payment determinations based on clinical/medical information and established criteria/protocol sets or clinical guidelines. Determines medical necessity and appropriateness and/or reasonableness and necessity for coverage and reimbursement. Documents medical rationale to justify payment or denial of services and/or supplies. Educates internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines. Participates in quality control activities in support of the corporate and team-based objectives. Provides guidance, direction, and input as needed to LPN team members. Provides education to non-medical staff through discussions, team meetings, classroom participation and feedback. Assists with special projects and specialty duties/responsibilities as assigned by Management. To Qualify For This Position, You'll Need The Following: Required Education: Associate's in a job related field Degree Equivalency: Graduate of Accredited School of Nursing Required Experience: 2 years clinical plus 1 year utilization/medical review, quality assurance, or home health, OR 3 years clinical. FOR PALMETTO GBA (CO. 033) ONLY: 2 years clinical experience plus 2 years utilization/medical review, quality assurance, or home health experience. Required Skills and Abilities: Working knowledge of managed care and various forms of health care delivery systems; strong clinical experience to include home health, rehabilitation, and/or broad medical surgical experience. Knowledge of specific criteria/protocol sets and the use of the same. Working knowledge of word processing software. Ability to work independently, prioritize effectively, and make sound decisions. Good judgment skills. Demonstrated customer service and organizational skills. Demonstrated oral and written communication skills. Ability to persuade, negotiate, or influence others. Analytical or critical thinking skills . Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Microsoft Office. Required Licenses and Certificates: Active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR, current active, unrestricted licensure/certification from the United States and in the state of hire in specialty area as required by hiring division/area. We Prefer That You Have The Following: Preferred Education: Bachelor's degree-Nursing or Graduate of accredited School of Nursing. Preferred Work Experience: 3 years-utilization/medical review, quality assurance, or home health, plus 5 years clinical experience. Preferred Skills and Abilities: Knowledge of spreadsheet and database software. Knowledge of Medicare and/or regulations/policies/instructions/provisions, home health, and/or system/processing procedures for medical review. Preferred Software and Other Tools: Working knowledge of Microsoft Excel, Access, or other spreadsheet database software. Work Environment: Typical office environment. May work from home. May involve travel from home to office. Work may involve remaining in a stationary position and operating a computer. Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.
    $44k-59k yearly est. Auto-Apply 5d ago
  • Senior Tax Reviewer

    Tax Goddess Business Services

    Remote job

    About the Company Tax Goddess (*********************** Our firm is recognized as the top 1% of Tax Strategists in the USA. With 19+ years of experience, We're not your average number crunchers we're a progressive, 100% digital CPA firm. So, if you can handle cloud computing and rock basic tech skills, you're in for a wild ride! Job Summary: As a Senior Tax Reviewer at TaxGoddess.com, you will play a critical role in ensuring the accuracy and compliance of tax returns prepared by our team. You will be responsible for reviewing complex tax filings, providing strategic tax planning advice, and mentoring junior staff. This remote position offers the flexibility to work from anywhere in the world while making a significant impact on the success of US-based businesses. Key Responsibilities: Tax Return Review: Review complex federal and state tax returns for businesses, including S-corporations, C-corporations, partnerships, and sole proprietorships, ensuring accuracy, compliance, and adherence to current tax laws. Identify and address potential tax issues, providing clear and actionable feedback to preparers. Ensure all tax filings are completed accurately and submitted on time. Strategic Tax Planning: Provide high-level tax planning and advisory services to clients, helping them minimize tax liabilities and optimize their financial strategies. Stay up-to-date with the latest tax laws and regulations to ensure clients are informed and compliant with any changes that may impact their business. Mentorship and Leadership: Mentor and support junior tax preparers, providing guidance on complex tax issues and reviewing their work to ensure quality and accuracy. Lead by example, fostering a collaborative and positive team environment in a fully remote setting. Client Communication: Communicate directly with clients to discuss their tax situations, provide recommendations, and answer any questions they may have. Maintain strong client relationships through regular communication and by delivering high-quality service. Continuous Improvement: Identify opportunities for process improvements within the tax review function to enhance efficiency and accuracy. Participate in training sessions and professional development to stay ahead of industry trends and advancements. Required Skills and Qualifications: Experience: A minimum of 10 years of experience in tax preparation with a strong focus on the US market. Certifications: CPA certification (or equivalent) is highly preferred. Extensive knowledge of US federal and state tax laws, regulations, and filing requirements. Strong analytical skills and attention to detail. Excellent communication skills, both written and verbal, with the ability to explain complex tax concepts to clients and team members. Proven ability to manage multiple projects and deadlines in a remote work environment. Proficiency in tax software and technology (e.g., QuickBooks, ProSeries, Lacerte, UltraTax, etc.). Experience with tax planning and providing strategic tax advice to businesses. Strong leadership skills and the ability to mentor and develop junior team members. Preferred Skills: Experience with international tax issues, especially in relation to US expatriates or businesses with global operations. Advanced knowledge of tax software, including automation and integration with other financial systems. Familiarity with cloud-based accounting and tax platforms. Mandatory System Requirements: Internet Speed: At least 10mbps CPU: Core i5 (8th generation minimum) or i7 (8th generation minimum) RAM: Minimum of 16GB Storage: Minimum 256GB SSD or 500GB HDD Operating System: Genuine Windows (Preferably Pro). Audio: A good quality headset preferably equipped with noise cancellation Video: A laptop/PC with webcam or a good-quality webcam Headset with noise cancellation Private Home-office Location To ensure the security of our firm, we can only consider candidates who have a Windows operating machine. Having Windows Pro would be a significant advantage. If you are a Mac user and wish to apply, please note that you will need to acquire a Windows operating machine once you are accepted to perform the job with us. Noteworthy Perks Awaiting You: Permanent Work from home. Paid training and a collaborative environment. Work-life balance with fun activities & events. Performance-based incentives and Staff Referral Bonus Program. Access to Taxation Expertise. Working Hours: Mandatory overlap (8:00 am to 12:00 noon Arizona time), with flexible remaining hours. At least 40 hours per week of guaranteed work. How to Apply: Must be willing to follow our hiring process: Fill up the jot form, Send your proposal along with your updated resume. Answer the Critical thinking through videoask along with a technical assessment Technical Interview with the Head of Department and the hiring team Behavioral interview with HR Hiring decision and job offer with HR department head Satisfactory Background and credit check No CHATGPT Responses to all assessments. Make your mark. Apply today! Tax Goddess provides equal contractor opportunities to applicants and staff without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law. Working Place: Scottsdale, Arizona, United States
    $46k-66k yearly est. 60d+ ago
  • Residential Reviewer

    Mountainseed Appraisal Management LLC 4.3company rating

    Remote job

    HOW YOU'LL MAKE A DIFFERENCE: This Residential Reviewer fills a remote role (work from home) in MountainSeed's Appraisal Review Department. The Residential Reviewer will be performing Standard 3 and 4 appraisal reviews for residential properties. The appraisal reviews are conducted on MountainSeed's review form. The scope of work consists of a desk review and does not include an opinion of value and there is no confirmation of data. All communications, including uploading and downloading of reports, occurs via email or our web portal. There is no printing, mailing, hard copies, etc. IN THIS ROLE, YOU'LL GET TO: Perform detailed technical and compliance reviews on residential real estate appraisals, USPAP Standard 3 & 4 Ensure that valuations are reasonably supported, credible and compliant with federal and state regulations, USPAP, FIRREA, bank policies and guidelines, and industry standards Ensuring all communication is conducted by ValuTrac system Communicate with appraisers for any report corrections and/or revisions Evaluate appraiser quality of work and provide feedback for maintenance of the Bank's appraisal panel Respond to inquiries from production staff, underwriters, and members of management regarding review decisions to resolve issues Apply for and maintain multiple state licenses to serve our clients Be able to commute for MountainSeed special projects Provide support to all areas of real estate lending as needed; demonstrate superior customer service to appraisers and employees Attend ongoing training for Commercial Real Estate Appraisal and Appraisal Reviews Attend Weekly team meetings THIS OPPORTUNITY IS FOR YOU IF YOU HAVE/ARE: Minimum - Certified residential appraiser credential in at least one state Additional state licenses a plus At least five (5) years of real-estate appraisal review experience working with or for regulated financial institutions Bachelor's degree in accounting, finance, economics or related field Familiarity with Residential Real Estate Appraisal terminology and the appropriate application of appraisal valuation techniques, appraisal methodology and understanding of appraisal theory. Knowledge of residential mortgage operations. Attention to detail for the identification of Errors and Omissions. Manage difficult problems involving multiple facets and variables in non-standardized situations. Successfully prioritize work assignments of varying complexities, track progress of said assignments, demonstrate strong organizational skills and complete work within established deadlines. Software proficiency in Microsoft Office Suite and Outlook. Establish and maintain effective and professional working relationships. Effective written and verbal communication skills. Maintain confidentiality. WHAT WE OFFER: 3 weeks of PTO, 13 company paid holidays, paid parental leave, and a flexible work environment. Medical, Dental, Vision, Life, Disability, and 401K plans begin the first of the month after 30 days of employment. OUR PURPOSE is to provide opportunities that help people thrive using their God-given abilities. OUR CORE VALUES: Be a Self-Starter. Continuously seek ways to improve yourself and the business, take responsibility, and act with urgency to solve problems. Be a Team Player. Prioritize team success over individual achievements, support your colleagues, and contribute to creating high-performing teams. Be a Patriot. Focus on the greater good of the organization, be honest about what's working, and passionately work towards making the company better. Do it Right. Uphold high standards and integrity, even when no one is watching, and always aim to do the right thing. Be Humble. Lead by serving others, value diverse perspectives, and remain open to new ideas and feedback. WHAT WE DO: As the largest commercial real estate services marketplace in the nation, MountainSeed MarketPlace offers a comprehensive range of appraisal management, review services, and more. MountainSeed Analytics platform provides real-time, accurate real estate data insights, helping clients make informed decisions in markets across the U.S. MountainSeed's Capital Markets Solutions including Loan Sale Advisory and Sale Leaseback Programs assist in enhancing an institution's financial health. MountainSeed is proud to be an Equal Opportunity Employer and provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, pregnancy, sexual orientation, or any other characteristic protected by law.
    $38k-51k yearly est. Auto-Apply 60d+ ago
  • Coding & OASIS Reviewer (PRN)

    Netsmart

    Remote job

    Are you a certified clinical documentation professional looking for flexible PRN work? Join our team as a Coding & OASIS Reviewer where your expertise in ICD-10 coding and OASIS review will help drive accuracy, compliance, and quality in post-acute care documentation. What You'll Do Review OASIS and document recommended changes in approved system Review ICD-10 coding and sequencing from documentation in the patient chart Complete documentation of results review; ensure workflow processes are timely and accurate Document reason for change and recommended reimbursement impact. Consistently meet chart equivalent targets and quality metrics What You'll Bring Required At least 1 year of experience medical coding or OASIS review work experience HCS-D certification HCS-O OR COS-C certification Proven ability to consistently meet deadlines High attention to detail with excellent organization skills Demonstrates learning agility; seeks out opportunities for teaching, support, and professional growth Preferred Quality assurance work experience in a post-acute setting Expectations Comfortable with remote work arrangements and virtual collaboration tools Physical demands include extended periods of sitting, computer use, and telephone communication Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate. Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart's sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart's third party screening provider. If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled. All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position. Netsmart's Job Applicant Privacy Notice may be found here.
    $39k-59k yearly est. Auto-Apply 60d+ ago
  • Medical Reviewer (DME)

    Broadway Ventures 4.2company rating

    Remote job

    At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Are you a dedicated RN looking for a rewarding career in medical claims review? Broadway Ventures is seeking an experienced Registered Nurse (RN) to conduct pre- and post-payment medical reviews. This is an exciting opportunity to apply your clinical expertise in a non-traditional setting while making a meaningful impact on healthcare compliance and claim accuracy. About the Role: As a Medical Claims Reviewer, you will conduct medical reviews for Durable Medical Equipment (DME) claims. Using clinical expertise and established guidelines, you will assess claims, determine medical necessity, and document decisions. This role involves collaboration with providers and internal teams to ensure compliance and accuracy in claims processing. Position Details: Work Location: Remote: Work from home with high-speed (non-satellite) internet and a private home office. On-Site: Candidates living within driving distance of Nashville, TN will work in our Nashville office. Schedule: Monday - Friday, 8:00 AM to 5:00 PM CT Employment Type: Full-time (40 hours/week) Key Responsibilities: Conduct medical claim reviews for complex services, pre-authorizations, appeals, fraud investigations, and coding accuracy. Use established clinical guidelines and protocol sets to make coverage and reimbursement determinations. Ensure claims meet contractor standards and comply with Medicare guidelines. Document medical rationale for claim approvals or denials. Provide education and support to internal/external teams regarding medical reviews, coverage determinations, and coding procedures. Participate in quality control activities and support LPN team members. Assist with special projects and additional responsibilities as assigned. Qualifications - What You Need to Succeed: Required: Licensure: Active, unrestricted RN license in the U.S. (or active compact multistate RN license under the Nurse Licensure Compact - NLC). Education: Associate's degree in a related field OR graduate of an Accredited School of Nursing. Experience: Minimum two years of clinical nursing experience. Skills: Ability to work independently, prioritize tasks, and make sound decisions. Strong analytical, critical thinking, and organizational skills. Proficiency in Microsoft Office and ability to work with multiple software programs. Confidentiality: Ability to handle sensitive information with discretion. Preferred: Medicare Part B experience Medicare DME claims experience (strongly preferred) Intermediate computer proficiency with multitasking capabilities Perks & Benefits: 401(k) with company match Dental insurance Medical insurance Life & Disability insurance Paid Time Off - the longer you stay, the more you earn! Paid Holidays How to Apply: If you're a licensed RN looking for a remote opportunity in medical claims review, we'd love to hear from you! APPLY NOW to join Broadway Ventures and contribute to meaningful work in healthcare compliance and claims accuracy. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.
    $42k-60k yearly est. Auto-Apply 5d ago
  • New York Real Estate Curriculum Reviewer (Contract)

    Study.com 3.9company rating

    Remote job

    New York Real Estate Curriculum Reviewer (Contract) Study.com is looking for Real Estate experts to evaluate and update Study.com's Real Estate content to ensure it meets current academic standards and industry requirements. Our ideal expert is knowledgeable in their field, detail-oriented, and capable of analyzing content organization. This is an online, remote contract role. Work will be paid hourly. Project Description Your role would include the following responsibilities: Research and Analysis: • Conduct comprehensive research on state-specific real estate licensing requirements • Stay updated on changes in real estate laws, regulations, and exam content outlines in the target states Course Auditing: • Review and audit existing courses for brokers and salespersons to ensure content accuracy and compliance with state requirements • Identify gaps or outdated information in course materials and recommend updates Question Bank Management: • Audit the existing practice question bank to ensure alignment with current state exam questions and formats • Review and evaluate new practice questions for relevance, accuracy, and compliance with state-specific regulations • Revise and update practice questions as needed to maintain the highest quality standards Required Skills: Active real estate license in good standing Minimum of five years of experience in the real estate industry Demonstrated expertise in state-specific real estate licensing requirements, particularly in NY Proficiency in using educational technology tools and platforms Additional Preferred Skills: Familiarity with online training courses for licensing and continuing education What We Offer: Reliable Payments: You'll receive payments twice a month and automated invoicing for your work. Remote Work: This is a fully online contracted work-from-home opportunity. Flexibility: Basically, there are no requirements! Work when you want, where you want, as often as you want, with no minimums/maximums. Support: Our supportive staff is available answer your questions and help you get up and running. About Study.com The mission of Study.com is to make education accessible, and over the last two decades we've become the leading online education platform, delivering a personalized learning experience across a broad continuum of education for over 30 million students, instructors, and professionals every month. We help empower millions of learners to achieve their education and career goals. We focus on increasing access to education because we know information is the ultimate equalizer and that education is key to upward mobility. Feel free to share this opportunity with any friends you think would be interested, too.
    $40k-60k yearly est. Auto-Apply 60d ago
  • BPO reviewer

    Infinity International Processing Services 3.9company rating

    Remote job

    Infinity International Processing Services, Inc. is a leading provider of Broker Price Opinion (BPO) Quality Assurance ( Clerical Review) services to BPO/Appraisal Management Companies and Mortgage Lenders. We also provide Knowledge Process Outsourcing (KPO) and Business Process Outsourcing (BPO) services to 120+ global clients in Mortgage, Logistics, Finance & Accounting and Insurance industry. We are a global outfit having offices in Rockville, MD and India employing 1000+ employees. Towards our rapid expansion plan, we are recruiting clerical/administrative Broker Price Opinion (BPO) Reviewer cum Trainer. Job Description Responsibilities will involve reviewing of externally prepared broker price opinion reports for Clerical/Administrative errors and assuring compliance. Qualifications • Minimum of 10+ years of BPO review experience • Must be able to employ proper application of valuation techniques and methodologies • Travelling 30% ( Domestic/ International) • May have to travel to client's place for process training/transition • Handle client relation during test and ramp-up phase of new projects • Travel to offshore delivery centers in India and assist in training, project transition & ramp-up • Once offshore resources are ramped up, perform quality control • Must be able to work in a high volume production environment and meet deadlines • Good telephonic etiquette • Self prioritize tasks & work towards the same • Perform other related duties as assigned or directed by the management Additional Information Key Responsibilities:  Reviews BPOs for compliance with applicable USPAP, Fannie Mae, FHA, and client reporting guidelines, as well as completeness, consistency, logic, and appropriate valuation methodology  Approve or reject reports, requesting additional information as needed, and re-reviewing revised reports as they are received back from outside appraisers Job Type: Permanent / Work from home
    $44k-61k yearly est. 11h ago
  • Technical / Grammatical Reviewer - REMOTE

    Sol Engineering Services LLC

    Remote job

    TECHNICAL / GRAMMATICAL DOCUMENT REVIEWER- REMOTE Vicksburg, MS SOL Engineering Services, LLC is an engineering and technical services provider, with over 20 years of engineering and consulting experience. Our viability comes, in part, from utilizing the diverse backgrounds of the firm's owners and the experiences of its team of approximately one hundred engineers, scientists, technical subject matter experts, and program and project managers. Our hands-on project implementation approach encompasses management, quality, and engineering principles to ensure effective management and delivery of all projects. SOL's reputation and keys to success are built on providing high quality, responsive engineering and related technical services while maintaining professional commitments and ensuring that full satisfaction is given to our clients throughout the United States. SOL Engineering Services, LLC is searching for a Technical / Grammatical Document Reviewer to review draft documents and analyze graphic and technical information, to provide specific feedback to the authors for their consideration with respect to technical or grammatical points. Requirements Requires at least a BS/BA in English or similar, related field where the individual has demonstrated skills in reviewing written material and assuring sound grammatical structure, formatting, organization, technical content, punctuation, and structure. Requires strong technical acumen related to engineering and/or scientific research. Technical documents may include but technical reports, papers, journal articles, military field manuals, abstracts, technical letters, special reports, and presentation briefings. Must be able to format, edit and proof written work products, and ensure all materials meet established standards of appearance, consistency, and content under tight schedules and strict deadlines. Must be a U.S. citizen, able to pass a background investigation (financial and criminal) and apply for and maintain up to a Secret clearance, as well as having a valid driver's license. Solid Mathematics and basic computer skills are desirable. Work will be conducted in an office setting, and teleworking may be an option. No travel will be required. We offer a competitive salary, health benefits and paid vacation. Veterans and HUBZone residents are encouraged to apply. Equal Opportunity Employer
    $44k-64k yearly est. Auto-Apply 60d+ ago
  • Accreditation Reviewer

    Council of Autism Service Prov

    Remote job

    We are growing! The Autism Commission on Quality (ACQ) is a nonprofit accreditation agency for organizations offering applied behavior analysis services to individuals and families impacted by autism, and we are looking for an additional Accreditation Reviewer. ACQ is a subsidiary of the Council of Autism Service Providers (CASP), a nationally recognized 501(c)(6) nonprofit trade association for autism service providers, with over 400 members serving over 150,000 individuals impacted by autism. The Accreditation Reviewer plays a critical role in stabilizing and shaping the applied behavior analysis (ABA) industry by participating in review activities and evaluating applicants for accreditation against ACQ's standards. DUTIES & RESPONSIBILITIES Conducts reviews of applications for accreditation Participates in investigations and audits of accredited organizations Interviews applicant representatives about their administrative and/or clinical operations Identifies recommendations, strengths, and areas for improvement for organizations applying for accreditation Presents formal accreditation reports, notifications, and recommendations for ACQ, committee members, and applicants Stays current on applicable standards, laws, and regulations Works collaboratively with review team members, applicants, committee members, and consultants Maintains weekly time logs to track time spent on review activities Assists with other administrative duties and projects as needed MINIMUM QUALIFICATIONS Broad familiarity with applicable laws, regulations, and standards relevant to the practice of ABA as a healthcare service. BCBA or BCBA-D certification in good standing with at least five (5) years of clinical experience delivering and overseeing applied behavior analysis as a healthcare service for individuals with autism OR at least five (5) years of experience overseeing administrative operations, quality improvement, and/or compliance activities within an organization offering applied behavior analysis as a healthcare service for individuals with autism. BENEFITS Competitive salary: $80,000-$90,000 commensurate with experience. Remote work with flexible hours Comprehensive insurance coverage, including medical, dental, and vision Flexible time off to support a great work-life balance World-class 401(k) plan allowing pre-tax and Roth contributions Professional development opportunities for continuous learning Access to industry leaders involved in supporting ACQ's mission EQUAL OPPORTUNITY AND NONDISCRIMINATION The Council of Autism Service Providers (CASP) is an equal opportunity employer and makes all employment decisions on the basis of merit, qualifications, and abilities. CASP is committed to providing a work environment free of unlawful discrimination and harassment, including sexual harassment.
    $80k-90k yearly 60d+ ago

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