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 ...
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 ...
Work From Home Remote Entry Level -Focus Group Position
Redmond, OR · Remote
$16.50 - $21/hr
Join Our Team as a Work-From-Home Data Entry Research Panelist! Are you ready to earn money from ... Enjoy the freedom of remote work while building your career. This role is your chance to turn your ...
Work From Home Remote Entry Level -Focus Group Position
Redmond, OR · Remote
$16.50 - $21/hr
Join Our Team as a Work-From-Home Data Entry Research Panelist! Are you ready to earn money from ... Enjoy the freedom of remote work while building your career. This role is your chance to turn your ...
... our team as Remote Customer Support Advocates. From your own home, you'll ensure exceptional service levels and foster positive interactions with a wide-ranging clientele. Responsibilities:
... our team as Remote Customer Support Advocates. From your own home, you'll ensure exceptional service levels and foster positive interactions with a wide-ranging clientele. Responsibilities:
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
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 ...
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
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 ...
Part Time Pharmacist, 7on/7off, Evenings
Salem, OR · Remote
$58.50 - $70.25/hr
This is a work from home opportunity completing remote order verification for health care facilities throughout the New England area, Ohio and Pennsylvania. Candidates must have an active pharmacist ...
Part Time Pharmacist, 7on/7off, Evenings
Salem, OR · Remote
$58.50 - $70.25/hr
This is a work from home opportunity completing remote order verification for health care facilities throughout the New England area, Ohio and Pennsylvania. Candidates must have an active pharmacist ...
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
You would join a small, fun & amazing team in a full-time work-from-home (remote) position. Ideally, you will bring full-cycle recruiting experience and have recruited for technical (I.T.) positions.
Sales Executive -
OR · Remote
Business Development Executive in the US/Caribbean Markets! WORK FROM ANYWHERE - remote opportunity Position Overview: We are seeking a highly motivated and experienced Business Developer to join our ...
Quick apply
Sales Executive -
OR · Remote
Business Development Executive in the US/Caribbean Markets! WORK FROM ANYWHERE - remote opportunity Position Overview: We are seeking a highly motivated and experienced Business Developer to join our ...
Remote Recruiter
OR · Remote
$55K - $58K/yr
Seattle is our home and headquarters. We've been successful in this unique business for over 30 years and we continue to advance our technology and business processes to remain years ahead of what ...
Remote Recruiter
OR · Remote
$55K - $58K/yr
Seattle is our home and headquarters. We've been successful in this unique business for over 30 years and we continue to advance our technology and business processes to remain years ahead of what ...
A leading interpreting services company seeks Tagalog Telephonic Interpreters for remote positions. This role allows you to work from home, setting your schedule while managing a high volume of calls.
A leading interpreting services company seeks Tagalog Telephonic Interpreters for remote positions. This role allows you to work from home, setting your schedule while managing a high volume of calls.
Hausa Remote Interpreter (Freelance, Work-From-Home)
Portland, OR · Remote
$73.20K/yr
A leading interpreting services company seeks a Hausa Remote Interpreter for freelance, work-from-home roles. Candidates must be fluent in Hausa and meet legal work requirements in the United States.
Hausa Remote Interpreter (Freelance, Work-From-Home)
Portland, OR · Remote
$73.20K/yr
A leading interpreting services company seeks a Hausa Remote Interpreter for freelance, work-from-home roles. Candidates must be fluent in Hausa and meet legal work requirements in the United States.
Entry Level Remote Service Agent
Gresham, OR · On-site +1
$16.50 - $22/hr
Flexible Looking for a career that offers flexibility, stability, and meaningful work -all from the comfort of your home? This fully remote opportunity allows you to take control of your schedule ...
Entry Level Remote Service Agent
Gresham, OR · On-site +1
$16.50 - $22/hr
Flexible Looking for a career that offers flexibility, stability, and meaningful work -all from the comfort of your home? This fully remote opportunity allows you to take control of your schedule ...
A leading interpretation services provider is seeking a Remote Interpreter to provide over-the-phone interpretation services. This entry-level position allows you to work from home and set your own ...
A leading interpretation services provider is seeking a Remote Interpreter to provide over-the-phone interpretation services. This entry-level position allows you to work from home and set your own ...
REMOTE Support Specialist
Tigard, OR · On-site +1
Remote Client Support Representative 100% Work From Home | Flexible Schedule Our company has transitioned to a fully virtual, work-from-home model , offering a career that allows you to earn a strong ...
REMOTE Support Specialist
Tigard, OR · On-site +1
Remote Client Support Representative 100% Work From Home | Flexible Schedule Our company has transitioned to a fully virtual, work-from-home model , offering a career that allows you to earn a strong ...
Shipping Container Sales Work From Home Fully Remote
Lake Oswego, OR · Remote
$100K - $200K/yr
Join Quality Container Inc as a National Sales Manager and help customers find the perfect shipping container solutions from the comfort of your home! This fully remote position allows you to engage ...
Quick apply
Shipping Container Sales Work From Home Fully Remote
Lake Oswego, OR · Remote
$100K - $200K/yr
Join Quality Container Inc as a National Sales Manager and help customers find the perfect shipping container solutions from the comfort of your home! This fully remote position allows you to engage ...
Remote Prior Authorization Pharmacist
Beaverton, OR · Remote
$60.50 - $72.75/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription ...
Remote Prior Authorization Pharmacist
Beaverton, OR · Remote
$60.50 - $72.75/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription ...
Benefit Specialist - Entry Level (Remote)
Bend, OR · On-site +1
You'll work independently from home while remaining connected to a collaborative and supportive remote team. This entry-level opportunity is ideal for individuals seeking long-term growth, mentorship ...
Benefit Specialist - Entry Level (Remote)
Bend, OR · On-site +1
You'll work independently from home while remaining connected to a collaborative and supportive remote team. This entry-level opportunity is ideal for individuals seeking long-term growth, mentorship ...
Remote Prior Authorization Pharmacist
Portland, OR · Remote
$59.50 - $71.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription ...
Remote Prior Authorization Pharmacist
Portland, OR · Remote
$59.50 - $71.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription ...
Remote Travel Customer Representative
Salem, OR · Remote
$16 - $21.75/hr
In this 100% work-from-home role, you will assist clients with travel-related questions, provide ... remote team environment #J-18808-Ljbffr
Remote Travel Customer Representative
Salem, OR · Remote
$16 - $21.75/hr
In this 100% work-from-home role, you will assist clients with travel-related questions, provide ... remote team environment #J-18808-Ljbffr
Home Remote information
What are the key skills and qualifications needed to thrive as a Remote Worker, and why are they important?
What are some common challenges faced by professionals working in home remote roles, and how can they be managed?
What are home remote jobs?
What is the difference between Home Remote vs Customer Service Representative?
| Aspect | Home Remote | Customer Service Representative |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require specific certifications | High school diploma or equivalent; customer service training often preferred |
| Work Environment | Remote, home-based setting with flexible hours | Typically office or call center, but increasingly remote options available |
| Industry Usage | Used across various industries including tech, sales, and support | Primarily in retail, telecom, and service sectors |
| Common Search/Comparison | Yes | Yes |
Home Remote jobs and Customer Service Representative roles often overlap in work environment and required skills. While Home Remote positions offer flexibility and are suitable for those seeking remote work, Customer Service Representatives focus on assisting customers, often in call centers or online. Both roles are in high demand and frequently compared by job seekers looking for remote customer support opportunities.
Other
Posted 10 days ago
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
- 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