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Full Time Remote Clinical Reviewer Jobs in Puerto Rico

LifeLink

Remote Administrator on Call PR

Guaynabo, PR · On-site +1

... clinical management, allocation, recovery, and overall coordination of donor-related actions. The ... Engages in review, education, and required organizational meetings to promote best practice sharing ...

Huntington

Residential Review Appraiser - CRETS

Florida, PR · On-site +1

$76K - $83K/yr

Remote Our Approach to Office Workplace Type Certain positions outside our branch network may be ... Applicants must be currently authorized to work in the United States on a full-time basis.

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site +1

Process cases and request/maintain clinical documentation and transmit timely determinations via ... Remote/hybrid experience preferred * A minimum of 2-4 years' administrative experience and/or ...

OncoHealth

Case Review Representative

Guaynabo, PR · On-site +1

$13 - $15/hr

Remote/hybrid work experience preferred * A minimum of 2 years of healthcare related administrative ... Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation ...

RelateCare

$11/hr

Verifying and reviewing patient insurance coverage and benefit eligibility * Resolving patient ... Remote

UnitedHealth Group

$16.75 - $21.50/hr

Review and research insurance follow-up, and denied claims by navigating multiple systems ... This position is full-time (40 hours/week) with our site operating from Monday - Friday from 9:30AM ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

Veterans Health Administration

$124K - $400K/yr

Possible $1,000 per year reimbursement (must be full-time with board certification) Malpractice ... of clinical services to veteran patients pertaining general surgery conditions. Work Schedule:

All JobsClinical Reviewer JobsFull Time Remote Clinical Reviewer JobsFull Time Remote Clinical Reviewer Jobs in Puerto Rico

Full Time Remote Clinical Reviewer information

What is a Full Time Remote Clinical Reviewer?

A Full Time Remote Clinical Reviewer is a healthcare professional, often a nurse or physician, who evaluates medical records and clinical documentation from a remote location. Their primary role is to assess the medical necessity, appropriateness, and quality of healthcare services provided to patients, ensuring compliance with regulatory and insurance guidelines. They typically work for insurance companies, healthcare providers, or third-party review organizations. By working remotely, they can access digital medical records and communicate with other healthcare professionals through secure online systems. This role helps improve patient care, streamline billing processes, and reduce unnecessary medical costs.

How does a Full Time Remote Clinical Reviewer typically collaborate with healthcare providers and team members while working remotely?

As a Full Time Remote Clinical Reviewer, you will regularly collaborate with physicians, nurses, and administrative staff through secure digital platforms such as email, video conferencing, and electronic health record (EHR) systems. Effective communication is essential to clarify case details, obtain additional documentation, and ensure reviews meet compliance and quality standards. Despite working remotely, you will often participate in virtual team meetings, case discussions, and ongoing training sessions to stay updated on protocols and best practices.

What is the difference between Full Time Remote Clinical Reviewer vs Part Time Remote Clinical Reviewer?

AspectFull Time Remote Clinical ReviewerPart Time Remote Clinical Reviewer
Work HoursTypically 40 hours/weekLess than 20 hours/week
CertificationsRequired clinical credentials (e.g., RN, LPN, or relevant license)Same as full-time, but flexible scheduling
Work EnvironmentRemote, home-basedRemote, home-based
Employer UsageCommon in healthcare and insurance companiesSimilar, often for supplemental or flexible roles

Full Time Remote Clinical Reviewers work standard hours and are employed full-time, focusing on comprehensive case reviews. Part Time Remote Clinical Reviewers have flexible schedules with fewer hours, often for supplemental work. Both roles require relevant clinical credentials and are performed remotely within healthcare and insurance industries.

What are the key skills and qualifications needed to thrive as a Full Time Remote Clinical Reviewer, and why are they important?

To thrive as a Full Time Remote Clinical Reviewer, you need a solid background in healthcare, clinical assessment, and medical terminology, typically supported by a valid clinical license such as RN, LPN, or similar. Familiarity with utilization management software, electronic health record (EHR) systems, and relevant certifications like URAC or InterQual is often required. Strong attention to detail, critical thinking, and effective written communication are crucial soft skills for this role. These skills ensure accurate clinical evaluations, regulatory compliance, and clear communication in a remote work environment, directly impacting patient outcomes and organizational efficiency.
What are popular job titles related to Full Time Remote Clinical Reviewer jobs in Puerto Rico? For Full Time Remote Clinical Reviewer jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Full Time Remote Clinical Reviewer jobs in Puerto Rico look for? The top searched job categories for Full Time Remote Clinical Reviewer jobs in Puerto Rico are:
What cities in Puerto Rico are hiring for Full Time Remote Clinical Reviewer jobs? Cities in Puerto Rico with the most Full Time Remote Clinical Reviewer job openings:
Full Time Remote Clinical Reviewer jobs near you
Remote Administrator on Call PR

Remote Administrator on Call PR

LifeLink

Guaynabo, PR • On-site, Remote

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 11 days ago

Job description

As a Remote Administrator on Call, you will directly contribute to LifeLink's life-saving mission. The Remote Administrator-on-Call (Remote AOC) supports recovery services staff by overseeing activities related to donor assessment and recovery. Activities requiring direct oversight include, but are not limited to, identification, evaluation, approach, clinical management, allocation, recovery, and overall coordination of donor-related actions. The Remote Administrator-on-Call (Remote AOC) supports recovery services staff by overseeing activities related to donor assessment and recovery. Activities requiring direct oversight include, but are not limited to, identification, evaluation, approach, clinical management, allocation, recovery, and overall coordination of donor-related actions.
Key Responsibilities:
  • Works closely with the Referral Coordinator (RC) in the utilization of available staff and resources with the goal of providing the highest level of support and customer service to referring hospitals and organizations.
  • Maintains awareness of all active donors and referrals expected to provide the legal-next-of-kin with disclosure of donation status or approach for organ and tissue donation, ensuring use of appropriate resources.
  • Provides real-time direction and guidance to staff for identification, evaluation, authorization, clinical management, organ allocation, and surgical recovery directed towards maximizing every organ donation opportunity.
  • Proactively engages with staff to provide thorough, in-depth guidance utilizing highly developed clinical expertise and advanced knowledge of the organ donation process. Advises staff when working through operational challenges by providing mentoring, talking points, and coaching.
  • Participates in performance improvement initiatives, identifying trends and supporting formal staff education needs including involvement in regular case activity reviews.
  • Engages in review, education, and required organizational meetings to promote best practice sharing and interdepartmental collaboration.
  • Provides regulatory oversight and verification of critical aspects of the donation process such as brain death documentation, hemodilution, additional risk status, infectious disease testing results, allocation variances, and transplant center/surgeon issues.
  • Performs other duties as assigned.

Who You Are
  • Passionate about helping others and making a difference
  • Aligned with LifeLink's core values of Compassion, Excellence, Legacy, People, and Quality
  • Bachelor's degree or equivalent combination of education, management and/or AOC.
  • Minimum of three years' experience as procurement organization clinical coordinator or two years in management and/or AOC.
  • Advanced knowledge of human anatomy and medical terminology, organ perfusion, strong decision- making capabilities, and strong attention to detail.
  • Remain current on all LifeLink and OPTN policies, CMS regulations, and relevant state and federal laws.
  • Excellent verbal and written communication and customer service skills.
  • Ability to work within a high-paced and elevated stress environment due to the nature of work involving death and dying causing emotional and physical stressors.
  • Ability to prioritize remote work (computer and smart phone) to accomplish the goals for all active donors and referrals with the goal of meeting the needs of all stakeholders.
  • A collaborator who thrives in a mission-first environment

Why LifeLink?
  • Be part of an organization with a legacy of saving lives and giving hope
  • Join a passionate and supportive team across Florida, Georgia, and Puerto Rico
  • COMPANY PAID Medical, Dental, Disability & Life Insurance
  • Generous COMPANY PAID Pension Plan for your Retirement
  • Paid Vacation, Sick Days & Holidays
  • Growth opportunities in a mission-driven, high-impact nonprofit
  • Work with purpose, knowing your efforts directly touch lives

Diversity, Equity & Inclusion
LifeLink is proud to be an equal opportunity employer. We celebrate diversity and are committed to building an inclusive environment that reflects the communities we serve.
Ready to Help Change Lives?
Your next career move could be the most meaningful one yet.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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