Work From Home -AI Writing Reviewer - Remote
Remote job
Earn up to $16 USD/hourly and work fully remotely and flexibly.
Outlier, a platform owned and operated by Scale AI, is looking for English speakers to contribute their expertise toward training and refining cutting-edge AI systems. If you're passionate about improving models and excited by the future of AI, this is your opportunity to make a real impact.
What You'll Do
Work from a real user perspective to create natural, high quality data that reflects how people actually use AI in practice.
Review, compare, and rank responses generated by large language models, focusing on usefulness, clarity, and reasoning quality.
Contribute across a range of projects based on your skills, interests, and experience.
What We're Looking For
Analytical and Problem-Solving Skills: Ability to craft thoughtful prompts and evaluate nuanced AI responses with sound judgment.
Strong Written Communication: Clear, structured writing to explain decisions, provide feedback, and articulate why one response is stronger than another.
Care and Precision in Execution: A consistent ability to follow guidelines, notice subtle differences, and ensure outputs meet defined quality standards.
Nice to Have
Background in fields such as literature, creative writing, history, philosophy, theology, or similar disciplines.
Prior experience in writing or editorial roles, such as content strategy, technical writing, or editing.
Curiosity about AI systems, machine learning, or creative technology tools.
Pay & Logistics
Base Rate: depending on location: US $16.07, GB £ 13.30 GBP, CA $20.50 CAD, AU $26.25 AUD, IE €14.60 EUR, NZ $26.00 NZD
Bonuses: Additional pay available based on project performance.
Type: Freelance/1099 contract - not an internship.
Location: 100% remote
Schedule: Flexible hours - you choose when and how much to work.
Payouts: Weekly via our secure platform.
This is a freelance position that is paid on a per-hour basis. We don't offer internships as this is a freelance role. You also must be authorized to work in your country of residence, and we will not be providing sponsorship since this is a 1099 contract opportunity. However, if you are an international student, you may be able to sign up if you are on a visa. You should contact your tax/immigration advisor with specific questions regarding your circumstances. We are unable to provide any documentation supporting employment at this time. Please be advised that compensation rates may differ for non-US locations.
Telephonic Interviewer - A
Remote job
The nation's leading administrator of long-term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.
WE ARE THE KIND OF EMPLOYER YOU DESERVE.
illumifin is a leading provider of business process outsourcing for the insurance industry, managing over 1.3 million long-term care policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary long-term care databases.
The Telephonic Interviewer position performs interviews collecting information for clients who have applied for insurance coverage. We are seeking a schedule of Mon-Fri between hours of 1p-9p CST.
TELEPHONIC INTERVIEWER RESPONSIBILITIES
Conducts telephonic interviews for insurance company applicants in a quiet, professional environment without interruptions and/or distractions.
Receives calls from Assessment Services Call Center to complete telephone interviews with Long Term Care applicants with a pre-determined script.
Collects concise, accurate documentation on client's health history and care needs by asking follow-up questions when needed.
Accurately enters data and documents history and lifestyle information essential to the Underwriting process using pre-determined, scripted follow-up questions.
When necessary, tactfully refocuses applicants and/or contacts on information required.
Completes all interviews in a timely manner, according to department guidelines.
Submits document to Underwriting for review.
Uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
Meet established quality and production expectations communicated by the department.
May be required to attend department and organizational meetings.
Remote Telephonic Research Interviewer
Remote job
Remote Telephonic Research Interviewer (Work from Home)
GDCC is a telephonic data collection company that operates in The Netherlands, London, Istanbul, Hong Kong, Kosovo, Macedonia, and the USA. It is one of the industry leaders in market research across Europe.
We are currently recruiting work from home Telephonic Research Interviewers and across various shift times. Calls are made to business and the public within the United States. If you have experience of phone interviewing work (calling businesses or consumers), we would love to hear from you to add you to our pool of interviewing talent. NO SALES are involved; we conduct confidential market research only.
If you do not have previous experience of market research interviewing then we will provide online training for the right candidates.
Requirements
People who speak and read English fluently
Have excellent communication skills, and is highly motivated
Quiet work environment
No distractions or background noises
Have good keyboard skills
Reside in the United States (some states may not apply)
Eligible to work in the United States (Form I -9)
Experience: Call Center: 1 year (Preferred, not required)
Experience: High School Diploma or equivalent (Required)
Must be able to work at minimum 14 hours weekly
Can work independently with little supervision
Technical Requirements:
PC or laptop with Windows 10 or better OS
High speed internet service, such as fiber or cable
Corded mouse
USB headset with microphone, recommend JABRA or Logitech brand
Benefits
Remote work
Create your schedule for days, evenings, weekends
A dynamic, fast -paced, challenging environment
NO SALES involved; we do market research ONLY
Growth opportunities to progress within the company
#ZR
(Remote) Data Entry Work From Home / Focus Research Panelist
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!
Bilingual Telephone Interviewer - French
Remote job
Job DescriptionOn behalf of our client, Noor Staffing Group is currently seeking Bilingual French 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 (FRENCH)
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.
Telephone Interviewer - [A]
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
Auto-ApplyClinical Reviewer, Behavioral Health
Remote job
Who We Are
Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.
Job Summary
Under the supervision of the Utilization Management Supervisor, the Behavioral Health (BH) Utilization Management (UM) Clinician is responsible for conducting benefit coverage reviews and utilization management according to applicable regulatory guidelines and Enterprise contract requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership within the Behavioral Health department and other appropriate Point32Health staff to identify and address opportunities to improve service, reduce administrative cost, ensure clinically appropriate delivery of benefit covered services, and support department and organizational business goals. The UM BH Clinician escalates urgent issues and concerns that could potentially impact member needs, program compliance and or acute situations that pose risk. The UM BH Clinician must be committed to clinical and service excellence, including demonstrating the behaviors that support teamwork, collaboration, and professionalism. The BH UM clinician works under the direction of the UM Supervisor and in collaboration with the BH Operation Manager to ensure ongoing competency and learning needs are met that they are performing to applicable regulatory and clinical requirements.
Job Description
Key Responsibilities/Duties - what you will be doing (top five):
Adherence to established behavioral and administrative review guidelines and criteria
Adherence to timelines, standards, and elements associated with organizational determinations and notifications
Daily interactions with UM Support staff and providers to ensure clinical information and support are available and applicable to the review process
Appropriate prioritization of authorization requests
Achievement of expected productivity goals
Review of all assigned prior authorization requests including but not limited to inpatient admissions, specialty referrals, outpatient procedures, VNA or outpatient therapies as specified in the prior authorization list using specified clinical criteria sets.
Concurrent review of Behavior Health Services
Identification and determination of benefit coverage for behavioral health coverage requests.
Identifies and determines medical necessity of out of network requests for services.
Effective communication with the Medical Director, regarding identified variances for specific members according to criteria utilized for medical review.
Professional growth and development through self-directed learning activities and/or involvement in professional, civic, and community organizations
Ongoing referrals to and interactions with the case management team to ensure efficient and safe care transitions and member access to supportive programs and services
Works collaboratively with external providers to facilitate member access to high quality cost effective behavioral health services
Adheres to all regulatory and contractual requirements
Participates in department projects and special assignments as needed.
Attends scheduled meetings, training session in both classroom and computer-based required training sessions. Assist in development and updating of department workflows.
Other projects and duties as assigned.
Qualifications - what you need to perform the job
Certification and Licensure
Current unrestricted Massachusetts license in a behavioral health area of practice
Education
Required (minimum): BS Nursing; LICSW, LMHC, or other behavioral health profession qualified to practice independently.
Preferred:
Experience (minimum years required):
Required (minimum): Direct practice clinical experience in area of credential. Must demonstrate sound knowledge of utilization management and care management principles. Health Plan experience performing utilization review activities. Experience with McKesson's InterQual Clinical Screening Criteria.
Preferred: 3 years in a managed care environment in managed care systems and operations.
Skill Requirements
Ability to work cooperatively as a team member across multiple levels within the organization
Results orientation - strives to meet business goals
Critical and Analytic thinking, i.e., must understand cause and effect as it relates to workflow design and implications to policies, procedures, and other departmental functions
Comfort adapting to changes to business, market, regulatory, and strategic needs
Ability to influence others and serve as role model
Strong communications skills (formal and informal, written and verbal
Ability to handle multiple demands--must be able to balance multiple priorities
Regard for confidential data and adherence to corporate compliance policy
Proficiency with or ability to learn technology for initiating and participating in web/system-based communications: webinar, instant messaging, thin client, soft phone, or others
Proficiency with or ability to learn technology-based programs such as Microsoft Office Word and Excel; other programs as needed
Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):
Fast paced office environment handling multiple demands.
Must be able to exercise appropriate judgment when necessary and work and communicate with customers in a telephonic office environment
Must be able to work under normal office conditions and work from home as required.
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
May be required to work additional hours beyond standard work schedule.
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.
Salary Range
$76,114.60 -$114,171.90
Compensation & Total Rewards Overview
The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.
Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:
Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health
For more details on our total rewards programs, visit ***********************************************
We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_****************************
Auto-ApplyTelephone Interviewer - Bilingual English/Spanish
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.
Auto-ApplyContent Reviewer (Spanish)
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
Auto-ApplyPer Diem Coding & OASIS Reviewer
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
Auto-ApplyEnrollment Reporting Reviewer (onsite)
Remote job
Job Description
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.
Title Reviewer - Remote Work from Home!
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.
Auto-ApplyReviewer III, Medical
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.
Auto-ApplyResidential Reviewer
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.
Auto-ApplyCoding & OASIS Reviewer (PRN)
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.
Auto-ApplyCoding and OASIS Reviewer- Full Time/Remote Position
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.
Medical Reviewer (DME)
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.
Auto-ApplyNew York Real Estate Curriculum Reviewer (Contract)
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.
Auto-ApplyInfinity 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
Technical / Grammatical Reviewer - REMOTE
Remote job
Job Description
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