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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 ...
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 ...
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 ...
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AgencyHub.com - Work From Home
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We're looking for a Remote Sales Guru to join our team at AgencyHub. This is a fantastic opportunity to work from the comfort of your own home, anywhere in the USA -- but we'd prefer you to be in the ...
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Logistics Coordinator (Work From Home) - $1,800 to $3,500 Weekly
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Logistics Coordinator (Work From Home) - $1,800 to $3,500 Weekly
Salem, OR · Remote
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Logistics Coordinator (Work From Home) - $1,800 to $3,500 WeeklyEugene
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This is a remote opportunity where you'll work directly with individuals who have requested help ... No cold outreach * Work from anywhere * Income tied to effort, not time * Clear path to leadership ...
This is a remote opportunity where you'll work directly with individuals who have requested help ... No cold outreach * Work from anywhere * Income tied to effort, not time * Clear path to leadership ...
This is a remote opportunity where you'll work directly with individuals who have requested help ... No cold outreach * Work from anywhere * Income tied to effort, not time * Clear path to leadership ...
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From Home Remote Library information
What is the difference between From Home Remote Library vs From Home Remote Archivist?
| Aspect | From Home Remote Library | From Home Remote Archivist |
|---|---|---|
| Required Credentials | Library degree or certification, MLS preferred | Archival certification, MLS or related degree often required |
| Work Environment | Public or academic libraries, remote access to digital collections | Specialized archives, digital preservation, remote cataloging |
| Employer & Industry | Libraries, educational institutions, public sector | Historical societies, museums, research institutions |
| Search & Comparison Intent | Jobs involving remote library services | Remote archival and preservation roles |
While both roles involve working remotely in the library and information sector, From Home Remote Library focuses on providing library services and managing collections remotely, often in public or academic settings. From Home Remote Archivist specializes in preserving and cataloging historical or specialized collections remotely. The credentials, work environment, and industry usage overlap but serve different professional functions.
Job description
Job Type: Full-time (40 hours/week)
Schedule: Monday-Friday, 8:00 AM - 5:00 PM
Max Salary: W-2 ($60,000-$63,000)
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.
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.
- Provide guidance to LPN team members and support non-clinical staff through training and discussions.
- Assist with special projects and additional responsibilities as assigned.
- 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).
- Associate Degree in Nursing
OR - Graduate of an accredited School of Nursing.
- Two years of clinical experience plus at least two years in one of the following:
- Home Health (meets for both clinical and HH requirement for a total of 2 years)
- Utilization/Medical Review
- Quality Assurance
- Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical 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.
- Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
- Proficiency in using multiple screens and software programs simultaneously.
If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!
About BROADWAY VENTURES
Sourced by ZipRecruiter
Industry
Business management consulting
Company size
11 - 50 Employees
Headquarters location
Canton, MS, US
Year founded
2013