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Interviewer work from home jobs - 88 jobs

  • Bilingual Unemployment Compensation Claims Intake Interviewer - Scranton(Spanish-English)

    Commonwealth of Pennsylvania 3.9company rating

    Remote job

    Are you looking for a career in public service? If so, consider joining the Department of Labor and Industry (L&I), as a Bilingual (Spanish) Unemployment Compensation (UC) Claims Intake Interviewer. This position conducts interviews at the assigned PA CareerLink location both in person and by telephone. You will have the opportunity to provide assistance to UC claimants with initial, continued, or additional claims for unemployment benefits. Apply today to become an essential part of our team that provides Pennsylvanians with the efficient, timely customer service they deserve! DESCRIPTION OF WORK As a Bilingual Unemployment Compensation Claims Intake Interviewer, you will be responsible for conducting interviews with claimants to gather information and pertinent data to establish valid claims for benefits in accordance with Pennsylvania UC laws. Work involves entering and retrieving data, modifying records, processing claims, as well as identifying issues that may affect the eligibility of claimants for benefits. You will have the opportunity to contact claimants, employers, other service centers, or agent offices to obtain clarification of claims data to expedite processing of claims. Additional responsibilities include: Detecting non-monetary claim issues and referring claim to Adjudication Responding to telephone inquiries Reviewing incoming forms Maintaining computerized records of claims Interested in learning more? Additional details regarding this position can be found in the position description. Work Schedule and Additional Information: Full-time employment Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with 30-minute lunch. Works hours may vary based on operational needs. Note: Employees who pass the Spanish proficiency exam may be able to receive an incentive of up to $1.00 per hour for using their bilingual skills, following the employee's probationary period. Telework: You may have the opportunity to work from home (telework) part-time, upon successful completion of the required probationary period. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Scranton. The ability to telework is subject to change at any time. Additional details may be provided during the interview. Salary: In some cases, the starting salary may be non-negotiable. You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices. REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY QUALIFICATIONS Minimum Experience and Training Requirements: Successful completion of the Unemployment Compensation Intake Interviewer Trainee (commonwealth title) program; or Three years of customer service or office support experience which includes two years of experience resolving customer impact issues; or Any equivalent combination of experience or training which includes two years of experience resolving customer impact issues. Other Requirements: This position requires the selected candidate to be able to read, write, and speak in Spanish. You may be contacted for a Spanish speaking proficiency evaluation conducted by the Bureau of Talent Acquisition, PA Office of Administration. If contacted, you must pass the speaking evaluation in order to be deemed eligible for this position. Your proficiency in reading and writing in Spanish must be demonstrated during the probationary period to achieve regular status in the position. You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency. You must be able to perform essential job functions. Legal Requirements: This position will have access to Federal Tax Information (FTI) and is subject to the provisions of IRS Publication 1075 (Pub 1075) which requires you to pass an enhanced background check prior to beginning employment. Under Pub 1075, acceptance of a conditional offer of employment will require submission to and approval of satisfactory criminal history reports, including but not limited to: a fingerprint-based federal records check; a PA State Police clearance; a check of local law enforcement agencies where you have lived, worked, and/or attended school within the last five (5) years; and a citizenship/residency verification. How to Apply: Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education). If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable. Your application must be submitted by the posting closing date . Late applications and other required materials will not be accepted. Failure to comply with the above application requirements may eliminate you from consideration for this position. Veterans: Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans. Telecommunications Relay Service (TRS): 711 (hearing and speech disabilities or other individuals). If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date. The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply. EXAMINATION INFORMATION Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam). Your score is based on the detailed information you provide on your application and in response to the supplemental questions. Your score is valid for this specific posting only. You must provide complete and accurate information or: your score may be lower than deserved. you may be disqualified. You may only apply/test once for this posting. Your results will be provided via email.
    $31k-39k yearly est. 1d ago
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  • (Remote) Data Entry Work From Home / Focus Research Panelist

    Focusgrouppanel

    Remote job

    Work From Home, Entry Level Data Entry Clerk As A Research Participant We are looking for people who want to work remotely from home. You'll need an Internet connection and a mobile device or computer. We need folks who want to do tasks, micro tasks, work at home opinion panels, online focus groups, product testing, research trials and more. This is not a normal 9-5 job, but a fun way to earn extra cash working from home part time on the fly - work when you want. Apply today for free and start earning. Work from home from any location, any hours, any day. Your choice. All backgrounds welcome: Work from home, part time, Amazon, customer service representative, medical professional, remote work at home, drivers, administrative assistant, work from home customer service representative, registered nurse, web developer, assistant manager, pharmacy technician Requirements: Education varies by study - all education levels accepted Current USA resident Speak, read and understand English / Spanish a plus as more opportunity is available to you Able to focus and follow through This is a remote work from home part time gig, you'll need a computer, laptop or mobile device. Microsoft Word or Excel helpful as a tool to keep yourself organized, but not mandatory Here's what you need to get started LapTop. You may be asked to use your webcam. These types of studies typically pay more. You'll need a stable internet connection. You may be asked to conduct a study using your SmartPhone. Data entry skills. All studies require that you be able to read, write and take direction as well as type a minimum of 25 words per minute. Backgrounds in Customer Service, Administrative Assisting, Sales and Sales Support helpful but not mandatory Pay Info: Up to 250 hr. per single research study session up to $3,000 per multi-session research study We look forward to working with you! Connect with us via email by applying to this posting! This is for those with any work backgrounds such as Amazon, customer service representative, medical professional, drivers, medical receptionist, our folks come from all backgrounds!
    $25k-34k yearly est. Auto-Apply 60d+ ago
  • Bilingual Telephone Interviewer - Tagalog

    Noor WFS

    Remote job

    Job DescriptionOn behalf of our client, Noor Staffing Group is currently seeking Bilingual Tagalog Remote Interviewers to work from home as Telephone Interviewers. Bilingual Interviewers will call health plans to ask questions over the telephone about benefits and coverage as part of a budget-based quality control evaluation. The pay for this position is $15.00 per hour. Bilingual Interviewers will be asked to work between 5 to 6.5 hours per day, 25 - 30 hours per week. Interviewers must work the same daily schedule Monday - Friday. The position for staff will start in January 2026 and is expected to end on May 29, 2026. There is a required paid training that will begin the week of January 20, 2026. Training will be a combination of at-home study and webinar. As a Bilingual Telephone Interviewer, you will: Complete and pass all training activities in a timely manner Contact health plan call centers across the country to help Centers for Medicare and Medicaid Services (CMS) evaluate healthcare compliance Be on the phone the full shift and be comfortable making a high volume of calls with specific time constraints Read the questions clearly and verbatim to the participant Accurately record outcomes and issues Receive and apply feedback on interviewing skills and project protocols. Position Qualifications: Ability to read, speak, and write English fluently (all training is conducted and prepared in English) Ability to fluently read, speak, and comprehend (TAGALOG) Bilingual Telephone Interviewing experience, at least 6 months (preferably in a research setting or conducting calls with scripted telephone Strong attention to detail with ability to capture information quickly while conversing Past experience using technology as part of day-to-day tasks (preferred experience in collecting data using computer-assisted interviewing) High school diploma or GED required Background check required Working from home requirements: Must have your own laptop/computer for this role that can connect to AIR systems Hard-wired high-speed internet service with speeds above 50 mbps download/10 mbps upload required - must be able to connect via Ethernet cable connection if needed (within 25ft of workspace) Wireless/WIFI connection is allowed - must have modem/router, no hotspots Alternate telephone (i.e. cell) to use to access AIR systems as part of log in process and for communicating issues to project staff Proficiency with troubleshooting and using computers Quiet, private space in your home to conduct work Hours & Training: Attend and complete all required training AIR IT orientation session beginning week of January 19, 2026 On-line home study and certification beginning the week of January 26, 2026 5 to 6.5 hour shifts, some exceptions for 8-hour shifts 25 - 30 hours per week, Monday - Friday. No Weekend Hours required at this time. Interviewers are required to work the same shift daily (ex. 8 am - 2:30 pm Monday - Friday) Interviewers must commit to working 5 days a week with little to no cancellations for the duration of the project Successful completion of self-study and web-based training prior to outbound calling Successful completion of certification assessment (and retraining if needed) Project dialing to start on Monday, February 9, 2026 Benefits: Work from home! Paid training Consistent schedule offered - 25 to 30 hours per week with the possibility to work up to 40 hours per week based on performance, availability, and project needs Calling starts at 8:00 am and continues through approximately 11:00pm (in the Eastern Time Zone) Monday through Friday. AIR to provide some IT equipment and resources to work on the project (phone, headset, system access) The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job: Communicate through speech and listening Read text verbatim, meaning reading words exactly as they are written, from a laptop or computer screen Transport and manipulate equipment and materials weighing between 10-35 lbs. depending on your assignment Sit for long periods of time making phone calls All candidates must be available for the duration of the project. Continued employment eligibility is contingent upon successful completion of mandatory training, verified reference checks, a DMV background check, and criminal background check including Megan's Law. Equal Employment Opportunity Policy The Company is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation based on an individual's race (including, but not limited to, hair texture and protective hairstyles such as braids, locks, and twists), color, religion, religious creed (including religious dress and grooming practices), national origin, ancestry, citizenship, physical or mental disability, medical condition (including cancer and genetic characteristics), genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender (including gender identity and gender expression), age (40 years and over), sexual orientation, veteran and/or military status, protected medical leaves (requesting or approved for leave under the Family and Medical Leave Act or state law such as the California Family Rights Act), domestic violence victim status, political affiliation, or any other status protected by federal, state, or local laws. The Company is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement, transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment.
    $15 hourly 19d ago
  • Bill Reviewer III

    Intermed 4.2company rating

    Remote job

    Full-time Description Employee will work under limited supervision, meets daily production quotas in processing and auditing medical bills in accordance with the appropriate workers' compensation fee schedule by performing the following duties. This position may be considered to work from home under the following criteria: Essential Duties and Responsibilities: Codes medical bills into the company system with speed and accuracy, maintaining company production standards related to quantity and quality of output. Performs preliminary screening for appropriateness and medical necessity of services rendered. Uses CPT and ICD9/ICD10 codes, fee schedules, and other resource materials to determine appropriate reimbursement of billed services, including applicable fee schedule and/or repricing rational. Flags any problem bills to the BR supervisor. Communicates with clients and/or providers to clarify information. Forwards to Bill Review supervisor any unidentifiable unlisted procedure numbers. Ability to price hospital and surgery bills to applicable fee schedules. Ability to process reconsideration requests as assigned. May specialize in state specific or client specific areas of responsibility. Assists with bill review reporting functions (internal and external reports) May specialize in state specific or client specific areas of responsibility May assist is answering provider calls. May travel to other offices to assist with training Requirements Competency: To perform the job successfully, an individual should demonstrate the following competencies: Design - Demonstrates attention to detail. Oral Communication- Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions. Team Work - Supports everyone's efforts to succeed. Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly. Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High school diploma or general education degree (GED), plus minimum of one year data entry/medical billing experience; additional two years bill review experience in a workers' comp environment. Strong knowledge of CPT and ICD9/ICD10 coding and workers compensation fee schedules. Must be familiar with workers' compensation regulations and have good comprehension of company software system process. Certificates and Licenses: Must have Medical Bill Reviewer Designation - 40 hour initial certification plus continuing education hours of 16 hours every 2 years. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records. Salary Description $25.00 - $30.00
    $57k-72k yearly est. 60d+ ago
  • Telephone Interviewer - [A]

    University System of New Hampshire 4.3company rating

    Remote job

    USNH Employees should apply within Workday through the Jobs Hub app The Survey Center is not currently hiring but is accepting applications for future openings. We will contact applicants as positions become available. As a Telephone Interviewer, your primary responsibility will be to collect survey research data by conducting phone interviews. You will follow scripted questionnaires, which typically take 10-15 minutes to complete. Surveying software will guide you through the questions and record participants' responses. This role requires strong typing skills and comfort using a computer, including basic navigation through menus. You must be able to speak clearly and professionally using a telephone headset, and accurately record participants' verbal responses. This is an in-person position at our call center located on the Durham Campus. Remote work may be available after a probationary period employees in good standing who meet remote work requirements. Employees are expected to work between 8-20 hours per week. You will be responsible for selecting and maintaining your own schedule. Shifts are typically offered in 4-hour blocks: 9:00 AM - 1:00 PM 1:00 PM - 5:00 PM 5:00 PM - 9:00 PM Please note: Our work is project-based, so there may be short breaks between assignments. Compensation Pay Range: $13.00 This is an evergreen posting. While there may not be an immediate opening, we regularly hire for this position throughout the year. Applications are reviewed as opportunities become available. The University of New Hampshire is an R1 Carnegie classification research institution providing comprehensive, high-quality undergraduate and graduate programs of distinction. UNH is located in Durham on a 188-acre campus, 60 miles north of Boston and 8 miles from the Atlantic coast and is convenient to New Hampshire's lakes and mountains. There is a student enrollment of 13,000 students, with a full-time faculty of over 600, offering 90 undergraduate and more than 70 graduate programs. The University actively promotes a dynamic learning environment in which qualified individuals of differing perspectives, life experiences, and cultural backgrounds pursue academic goals with mutual respect and shared inquiry. EEO Statement The University System of New Hampshire is an Equal Opportunity/Equal Access employer. The University System is committed to creating an environment that values and supports diversity and inclusiveness across our campus communities and encourages applications from qualified individuals who will help us achieve this mission. The University System prohibits discrimination on the basis of race, color, religion, sex, age, national origin, sexual orientation, gender identity or expression, disability, genetic information, veteran status, or marital status. The pay range for this position is listed above. Actual offer will be based on skills, qualifications, experience, and internal equity, in addition to relevant business considerations. More information on benefits can be found here: USNH Employee Benefits | Human Resources Location: Durham Salary Grade: Adjunct Hourly Staff 00
    $13 hourly Auto-Apply 60d+ 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 26d ago
  • Medical Reviewer/Safety Reviewer III

    Actalent

    Remote job

    Job Description: Responsibilities as applicable: Take part in post-market safety surveillance activities for assigned medical devices and contribute to area projects and objectives. Identify issues and escalate them to the manager as necessary. Conduct medical safety assessments MSA for medical device complaints involving reported adverse events and occasionally technical events. This involves evaluating the seriousness of adverse events determining device relatedness and assessing whether a recurring malfunction could cause or contribute to serious injury or death. Maintain oversight of all incoming MSAs for timely completion to assist in on-time reporting Skills pharmaceutical, clinical research, regulatory Top Skills Details pharmaceutical,clinical research,regulatory Additional Skills & Qualifications Qualifications: BSN Degree or higher with active RN license Minimally 5-7 years of hands-on clinical experience Able to apply clinical knowledge to adverse event data collection and assessment. Competent in ability to present device safety event data orally and in writing. Adheres to policies and regulations. Must be Computer proficient Windows Word Excel. Experience Level Expert Level Job Type & Location This is a Contract position based out of North Chicago, IL. Pay and Benefits The pay range for this position is $40.00 - $50.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jan 27, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
    $40-50 hourly 8d ago
  • Telephone Interviewer - Bilingual English/Spanish

    Sqm Us, Inc. 3.6company rating

    Remote job

    SQM Group, a leader in customer and employee experience, is seeking Bilingual Telephone Interviewers in English and Spanish to gather feedback on customer satisfaction. Our mission is to help contact centers improve their customer and employee experience performance - one individual at a time. The ideal candidates for the Telephone Interviewer position will take pride in gathering professional customer experience feedback for Fortune 500 contact centers throughout North America. These positions are scheduled for Monday to Friday from 9:00 AM to 5:30 PM. Save money on gas by remotely working from your home in the state of Idaho. To work remotely, you must have a quiet and distraction-free working space with an internet connection speed of at least 50 Mbps down and 15 Mbps up. The responsibilities of the interviewer are to conduct telephone interviews with customers of our clients. This is not a telemarketing job; there is no soliciting of customers. Interviewers must follow SQM standards and scripting while accurately documenting responses and demonstrating good judgment. The interviewer is at a desk for long periods of time. Due to standardization, the job can be repetitive but rewarding for the right candidate. This position is considered a less stressful or complex job than typical customer service positions. Qualifications: Computer knowledge and not intimidated by technology Fluent in reading and writing in English and Spanish Competent keyboarding skills (at least 40 WPM with high accuracy) 1 to 3 years of general working experience Responsibilities: Ability to follow SQM standards, scripts, and verbal instructions Accurate documentation skills Excellent listening and interpersonal skills Clear and effective communication with a professional telephone manner Demonstrate good judgment Accept repetitiveness of job We Offer: Day shift, full-time schedule M-F from 9:00 AM to 5:30 PM PT Work from home Paid Time Off Wages starting at $18.00 per hour with monthly performance bonuses of up to $350 available We offer a comprehensive benefit package that includes Health, Dental and Vision Insurance; Company Provided Short- and Long-Term Disability and Life Insurance, and 401k Only those selected for an interview will be contacted. Upon hiring, all employees are required to do background screening which will be organized by SQM. We are an equal opportunity employer. It is our policy to provide equal employment opportunity to all persons, regardless of race, religion, color, sex, age, national origin, disability, genetic information or any factor that is a prohibited consideration under applicable law.
    $18 hourly Auto-Apply 60d+ ago
  • Remote Content Reviewer

    Generalwebers

    Remote job

    The Remote Content Reviewer is responsible for evaluating, editing, and ensuring the quality, accuracy, and appropriateness of digital content across various platforms. This role involves reviewing text, images, and multimedia materials to confirm compliance with company guidelines, legal standards, and brand voice. The Content Reviewer will play a key role in maintaining a high standard of content integrity and user experience. Key Responsibilities: Review and evaluate user-generated or company-produced content for accuracy, relevance, and adherence to established guidelines. Edit and provide feedback on content to ensure clarity, correctness, and consistency with brand standards. Identify and escalate inappropriate, offensive, or non-compliant content as necessary. Collaborate with content creators, editors, and moderators to address quality issues and develop best practices. Maintain accurate records of reviewed content, flagged items, and actions taken. Stay up to date with changes in company policies, industry regulations, and content moderation practices. Participate in regular training and calibration sessions to ensure consistency in content evaluation. Ensure all content reviews maintain strict confidentiality and comply with data privacy standards. Provide suggestions for process improvements to enhance workflow efficiency and content quality. Qualifications: Bachelor's degree in English, Communications, Media Studies, or a related field, or equivalent work experience. Minimum of 2 years of experience in content review, editing, moderation, or a related digital role. Exceptional attention to detail and ability to follow complex guidelines precisely. Excellent written and verbal communication skills. Strong analytical, organizational, and time management skills. Proficiency with content management systems and digital collaboration tools. Ability to work independently and efficiently in a remote environment. U.S. residency is required; applications from outside the United States will not be considered. Compensation and Benefits: Annual Salary Range: $48,000 - $62,000, depending on experience, education, and location within the U.S. Benefits Package: Comprehensive health, dental, and vision insurance 401(k) retirement plan with employer match Paid time off (vacation, holidays, sick leave) Professional development and training support Flexible remote work arrangements Employee wellness and assistance programs
    $48k-62k yearly 29d ago
  • Distribution Reviewer

    Nova 401 4.1company rating

    Remote job

    Are you looking for a position where you can utilize your experience processing retirement plan distributions and loans? Do you excel at attention to detail and catching oversights? Do you want the flexibility and convenience of working from home? Nova 401(k) Associates is looking to fill a fully remote Distribution Reviewer position. The ideal candidate for this position has at least five years of experience processing distributions and loans for qualified retirement plans, with at least two years working in a remote working environment. In this position, you will provide work quality review for retirement plan loan and distribution requests. Nova 401(k) Associates is a vibrant and growing national third party, non-producing administration firm. We have a nationally recognized sales team allowing us to grow continuously and provide advancement opportunities for our professionals. Job Responsibilities: Review distribution and loan packages, including vesting verifications Work on more complicated distributions such as QDROs, death benefits, disability benefits, and Roth conversions as needed Assist with reviewing minimum required distributions and/or ADP/ACP refunds as needed Consider cyber security issues throughout review process Exemplify thorough understanding and interpretation of plan documents regarding distributions and loans Update account managers, management, and plan sponsors as necessary on requests and progress Pursue and attain NIPA's Distribution Administrator and Loan Administrator Certificates within one month of hire Perform other related duties as required Qualifications: Five or more years of experience processing retirement plan loans and distributions Strong knowledge of ERISA and Internal Revenue Code and Regulations specific to distributions Ability to establish priorities, work independently, and proceed with objectives without supervision Superior organizational and coordination skills Flexibility, adaptability, and ability to multi-task Coachable and committed to professional development Knowledge of Corbel Documents & Pension Pro is a plus Bachelor's degree preferred Compensation and Benefits: Base Pay: $55,000 - $70,000 Salaried, non-exempt Medical, dental, disability, and life insurance 401(k) plan with Employer Match Work Location/Hours: Work from Home Must work from USA and be authorized to work for any US employer We will supply all necessary computer equipment 40 hour work week Must work each day, Monday through Friday Must work a regular schedule during normal business hours We get it. We listen. We communicate. Click Here to review our Privacy Policy
    $55k-70k yearly Auto-Apply 13d ago
  • Clinical Reviewer - SCA (Remote - RN/LPN)

    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 seeks a Clinical Reviewer to join our growing team. Job Summary: The Clinical Reviewer utilizes clinical expertise during beneficiary interaction in conjunction with contract requirements, critical thinking and utilize decision-making skills to assist with communicating medical appropriateness, while maintaining production goals and QA standards. Ensures day-to-day processes are conducted in accordance with NCQA and other regulatory standards. * Shift Information: This position requires availability to work between 12pm - 8:30pm EST for an 8-hour shift and 10am - 8:30pm EST for a 10-hour shift. This position may also require a weekend and holiday rotation.* Job Responsibilities: * Assures accuracy and timeliness of all applicable review type cases within contract requirements * Assesses, evaluates, and addresses daily workload and call 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 or RN license in the applicable state and/or a Compact State license. * Knowledge of the organization of medical records, medical terminology, and disease process required * Strong clinical assessment and critical thinking skills required * Medical record abstracting skills required * 2+ years of clinical experience in a hospital or post-acute environment required. Preferred Qualifications * Minimum of one year UR and/or Prior Authorization or related experience. * Requires excellent written and verbal communication skills * Must be proficient in Microsoft Office and internet/web navigation * 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 is preferred * Experience in call center environment a plus * Experience in a behavioral health setting a plus * Bilingual (English/Spanish) a plus 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 nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career. 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 interest you. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at ******************************** EOE 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, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Compensation The pay range for this position is below: "Based on our compensation philosophy, an applicant's placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $28.37 - USD $33.00 /Hr.
    $28.4-33 hourly 8d ago
  • PEER REVIEWER - ORTHOPEDIC SPINE - REMOTE

    Michigan Peer Review Organization 4.3company rating

    Remote job

    iMPROve Health is seeking a Orthopedic Spine Physician to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type. BENEFITS: * Make a Difference: Use your clinical knowledge to improve the quality of care patients receive. * Professional Recognition: Join a network of highly respected experts in your specialty. * Competitive Compensation: Receive fair pay for your time and expertise. * Protect Standards of Care: Help uphold the integrity of your profession. * Work Remotely: Review cases from the convenience of your home or office. DUTIES AND RESPONSIBILITIES: * Conduct objective, evidence-based peer reviews of clinical cases. * Make final determinations regarding medical necessity and quality of care. * Ensure decisions are fair, unbiased, and aligned with current standards of practice. * Submit reviews in a timely and professional manner using the IT systems provided. QUALIFICATIONS: * Medical License: Must hold an unrestricted medical license in any U.S. state. * Board Certification:Required (if applicable), through a board recognized by: * The American Board of Medical Specialties (ABMS), * The American Osteopathic Association (AOA), or * Another nationally recognized board granting certification. * Clinical Experience: * Have at least five (5) years full-time equivalent experience providing direct clinical care to patients. * Have experience providing direct clinical care to patients within the past three (3) years. * Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review. * Have the clinical expertise to manage the medical or behavioral health condition or disease under review. * Must be actively engaged in direct or virtual patient care for at least 20 hours per week. Administrative work does not qualify. TECHNOLOGY REQUIREMENTS: * Reliable Wi-Fi access. * Proficiency with Microsoft Word. * Access to a computer compatible with iMPROve Health's IT systems. OTHER REQUIREMENTS: * Must complete the electronic credentialing application and receive organizational approval prior to performing a case review. * Must complete a conflict of interest attestation upon credentialing and prior to performing a case review. * Active hospital medical staff privileges may be required, as applicable. * Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status. * Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews. EOE/VET/Disability
    $43k-63k yearly est. 17d 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
  • Elsevier Clinical Content Reviewer, Specialty Specific (Part-Time, Fixed Term Contract)

    Osmosis 3.8company rating

    Remote job

    Job Title: Clinical Content Reviewer - PT Fixed Term Contract About Elsevier A global leader in information and analytics, we help researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. Building on our publishing heritage, we combine quality information and vast data sets with analytics to support visionary science and research, health education and interactive learning, as well as exceptional healthcare and clinical practice. At Elsevier, your work contributes to the world's grand challenges and a more sustainable future. We harness innovative technologies to support science and healthcare to partner for a better world. About our Team Elsevier Health is a division of Elsevier that is committed to supporting clinicians, health leaders, educators and students to overcome the challenges they face every day. We support healthcare professionals throughout their career journey from education through to clinical practice. We believe that by providing evidence-based information, we can help empower clinicians to provide the best healthcare possible. About the Role In this role, you will work closely with Elsevier Health data and content teams to ensure accuracy of content. You will play a critical role in reviewing content that will support clinicians at the point of care and providing as-needed feedback throughout the content and product development cycle. We are only hiring MDs/DOs from the following specialties: Family Medicine, Radiology, Pathology, Anesthesiology, OB/GYN, and General Surgery Responsibilities * Collaborate with our multidisciplinary team to create and curate content focused on emerging medical technologies * Create, rate, and rank queries based on their relevance, safety, and efficacy, helping healthcare professionals make informed decisions. * Review and assess the potential impact of various technologies on medical practice, patient care, and clinical outcomes. * Stay abreast of the latest advancements in the field of healthcare technology to ensure the content remains current and up-to-date. * Provide expert insights and perspectives on the integration of emerging technologies in clinical settings. Requirements This is a part-time, fixed term PRN role. * Terminal medical degree (MD or DO), specializing in one of the following: Family Medicine, Radiology, Pathology, Anesthesiology, OB/GYN, and General Surgery * At least 2 years of post-residency clinical experience * Active and unencumbered US-based license * Direct point of care experience within the US * Demonstrated interest and engagement with emerging technologies * Be comfortable working autonomously in a fully remote environment, must have proficiency in Microsoft Office (Outlook, Teams, and Excel) Compensation and Benefits: * Pay: This role will pay between $70-$80 USD / hour depending on the type of projects. * Perks: Gain access to Elsevier Health products, join a community of talented clinicians, and have an impact on the next generation of health solutions Work in a way that works for you We promote a healthy work/life balance across the organization. With an average length of service of 9 years, we are confident that we offer an appealing working prospect for our people. With numerous wellbeing initiatives, shared parental leave, study assistance and sabbaticals, we will help you meet your immediate responsibilities and your long-term goals. Working flexible hours - flexing the times when you work in the day to help you fit everything in and work when you are the most productive Working with us We are an equal opportunity employer with a commitment to help you succeed. Here, you will find an inclusive, agile, collaborative, innovative and fun environment, where everyone has a part to play. Regardless of the team you join, we promote a diverse environment with co-workers who are passionate about what they do, and how they do it. Why join us? * Purposeful Work When you work with us, your work matters. You are part of an organization that nurtures your curiosity to stimulate innovation for the communities that we serve. * Growing Every Day Like the communities we serve, you are on a constant path of discovery to shape your career and personal development. * Colleagues Who Care You will be part of the Elsevier family. We will support your well-being and provide the flexibility you need to thrive at work and home.
    $49k-68k yearly est. Auto-Apply 60d+ ago
  • Coding and OASIS Reviewer- Full Time/Remote Position

    Healthcare Provider Solutions

    Remote job

    Our Company is seeking a full-time RN or licensed therapist coder/OASIS reviewer to join our team for home health, or home health and hospice coding, needed for immediate work in remote/work from home setting. Requirements: Must have home health or home health and hospice coding experience (cannot only be hospice experienced) Must be coding certified (BCHH-C or HCS-D), and OASIS certified (COS-C, COQS or HCS-O) for a minimum of 3 years. Must have minimum of 3 year of routine coding and OASIS review under your belt. Must be a career Coder focuses on coding /OASIS at present and for at least the past year. Knowledge of at least one EMR system and must have the ability to learn others quickly and work in them efficiently and productively Must have reliable high-speed internet 40 hours/week, full-time - Office hours Monday-Friday 8-4:30pm (Work Hours - Flexible) Organization and Time Management Skills: Excellent verbal & written communication skills (must be able to read, write, and follow directions in English) Work and make decisions independently Ability to work well with others Works well under pressure Adaptable and flexible Detail oriented Benefits: Company provided laptop, monitors, and coding book or coding Company paid cell phone stipend Company paid Home Care OASIS & Coding Certification fees as renewals occur Company provides access to online Coding Center and Coding Manual reimbursement Productivity Bonus! Calculated on Weekly Productivity! Paid time off (10 days first year after 60-day waiting period - - 15 days 2nd year +) Eleven paid holidays per year (2 are floating holidays) Retirement (SIMPLE) plan with company matching up to 3% of salary; available immediately Company paid medical and life insurance for employees; available upon eligibility Dental, vision, dependent and supplemental insurances; available at employee expense Job Type: Full-time Pay: From $70,000.00 per year Medical Specialty: Home Health Schedule: 8 hour shift Day shift Monday to Friday Supplemental Pay: Bonus pay Education: Bachelor's (Preferred) Experience: Coding/OASIS: 3 years (Preferred) Benefits: 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Work from home Application Question(s): Have you used Microsoft Office and/or Microsoft Teams? Are you able to navigate multiple tabs at once? Do you have basic computer skills? License/Certification: BCHH-C or HCS-D (Required) COS-C or COQS or HCS-O (Required) RN License (Required) Work Location: Remote Healthcare Provider Solutions is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic, information, pregnancy, protected veteran status or any other protected characteristic as outlined by federal, state, or local laws.
    $39k-59k yearly est. 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
  • Authorization Management Clinical Reviewer

    Wellsky

    Remote job

    As an Authorization Management Clinical Reviewer, you'll play a vital role in ensuring patients receive the right care at the right time. Your primary responsibility will be reviewing acute and post-acute authorizations before submission to the payer and verify medical necessity is met using InterQual guidelines. In this role, you'll collaborate with physicians, healthcare providers, and both internal and external stakeholders to support improved health outcomes. By following InterQual guidelines, you will ensure care is medically appropriate, high-quality, and cost-effective throughout the medical management process. What we're looking for: Strong acute-care clinical background with the ability to apply evidence-based guidelines. Proficiency with technology solutions, including Microsoft Office and utilization management support tools, familiarity with CarePort Care Management preferred. Licensed RN, with the ability to obtain other clinical state licensures, as needed. Flexibility to work up to two weekend shifts per month and in alignment with the following business hours: 8:00a - 8:00p (staggered shifts) eastern time on weekdays, 8:00a - 4:00p on Saturdays, and 12:00p - 4:00p on Sundays, except for WellSky-recognized holidays. Join us in shaping the future of healthcare - apply today! Key Responsibilities: Review acute and post-acute authorizations for medical necessity using InterQual guidelines. Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care. Participate in team meetings, educational activities, and interrater reliability testing to maintain review consistency and professional growth. Ensure compliance with federal, state, and accreditation standards, and identify opportunities to enhance communication or processes. Utilize knowledge of resources available in the healthcare system to assist physicians and patients effectively. Perform other job duties as assigned. Required Qualifications: Bachelor's Degree or equivalent work experience. Active RN License. At least 4-6 years relevant work experience. 2 years clinical acute nursing experience. 1-2 years' of hospital-based utilization management experience. Preferred Qualifications: Bachelor's Degree in Nursing. Denials and Appeals experience. Experience with managed care and CMS standards. UM/CM Knowledge of ICD / CPT / DRG's. Proficient in the use of window-based computer programs. Excellent verbal, written, and interpersonal communication skills. Critical thinking skills, creative problem solving, and proficient organization and planning skills. Experience with InterQual guidelines for acute-care and/or other clinical decision support tools, especially in utilization management and prior authorization processes. Experience with CarePort Care Management. Job Expectations: Willing to travel up to 30% based on business needs. Willing to work additional or irregular hours as needed. Must work in accordance with applicable security policies and procedures to safeguard company and client information. Must be able to sit and view a computer screen for extended periods of time. WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year
    $39k-59k yearly est. Auto-Apply 10d ago
  • Medical Reviewer (Medicare)

    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. Job Type: Full-time (40 hours/week) Schedule: Monday-Friday, 8:00 AM - 5:00 PM EST (core hours) (Flex between 6am/7pm EST) Location: Remote (U.S. - Work from home) Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed. About the Role: We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements. Key Responsibilities: Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals. Assess payment determinations using clinical information and established guidelines. Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement. Provide clear, well-documented rationales for service approvals or denials. Educate internal and external teams on medical review processes, coverage determinations, and coding requirements. Support quality control activities to meet corporate and team objectives. Assist with special projects and additional responsibilities as assigned. Minimum Qualifications: Licensure: Active, unrestricted RN license in the U.S. and in the state of hire OR Active compact multistate RN license (as defined by the Nurse Licensure Compact). Education: Associate Degree in Nursing OR Graduate of an accredited School of Nursing. Experience: Two years of clinical experience plus at least two years in one of the following: Inpatient/Outpatient settings (i.e. medical-surgical, rehabilitation, SNF, etc..) Utilization/Medical Review Quality Assurance Skills & Competencies: Strong clinical background in managed care and/or inpatient/outpatient settings. Ability to interpret and apply medical review criteria and clinical guidelines. Proficiency in Microsoft Office and word processing software. Strong analytical, organizational, and decision-making skills. Ability to work independently while managing priorities effectively. Excellent customer service, communication, and critical thinking skills. Ability to handle confidential information with discretion. Preferred Qualifications: Three years of clinical nursing experience in Inpatient/Outpatient settings, Utilization Review, Medical Review, or Quality Assurance (strongly preferred). Proficiency in using multiple screens and software programs simultaneously. Training and experience in ICD coding. What to Expect Next: After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting. Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law. Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).
    $42k-60k yearly est. Auto-Apply 2d 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. 2d ago

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