Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
Per Diem Coding & OASIS Reviewer
$32 - $38/hr
Overview BerryDunn is seeking a Per Diem Coding & OASIS Reviewer to join our Healthcare group. This ... This is a remote position requiring the Reviewer to work independently. Our Healthcare ...
Per Diem Coding & OASIS Reviewer
$32 - $38/hr
Overview BerryDunn is seeking a Per Diem Coding & OASIS Reviewer to join our Healthcare group. This ... This is a remote position requiring the Reviewer to work independently. Our Healthcare ...
Summary The Quality Registered Nurse (RN) is responsible for overseeing clinical quality, clinic ... Primarily remote or hybrid, with periodic travel to clinic sites as needed * Collaborative, fast ...
Summary The Quality Registered Nurse (RN) is responsible for overseeing clinical quality, clinic ... Primarily remote or hybrid, with periodic travel to clinic sites as needed * Collaborative, fast ...
NCLEX-RN Tutor
Eugene, OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
NCLEX-RN Tutor
Eugene, OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
NCLEX-RN Tutor
Portland, OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
NCLEX-RN Tutor
Portland, OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
NCLEX-RN Tutor
OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
NCLEX-RN Tutor
OR · Remote
$40/hr
... online NCLEX-RN tutors nationally. As a tutor on the Varsity Tutors Platform, you'll have the ... Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions ...
Case Manager, Registered Nurse
Salem, OR · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... A RN who resides in a compact state is required to have an active multistate license through the ...
Case Manager, Registered Nurse
Salem, OR · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... A RN who resides in a compact state is required to have an active multistate license through the ...
Nurse (Post Baccalaureate RN Residency Program Manager)
Portland, OR · On-site +1
$116K - $169K/yr
... per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year ... to become registered as a nurse with a state licensing board prior to completion of the bridge ...
Nurse (Post Baccalaureate RN Residency Program Manager)
Portland, OR · On-site +1
$116K - $169K/yr
... per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year ... to become registered as a nurse with a state licensing board prior to completion of the bridge ...
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
Appeals RN (Temporary)
$50/hr
Registered Nurse with current unrestricted Registered Nurse license required. Certification in Case ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...
Appeals RN (Temporary)
$50/hr
Registered Nurse with current unrestricted Registered Nurse license required. Certification in Case ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · Remote
$67K - $126K/yr
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · Remote
$67K - $126K/yr
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · Remote
$67K - $126K/yr
If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional ... This is a remote position however, you will be required to report into the office twice a month per ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · Remote
$67K - $126K/yr
If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional ... This is a remote position however, you will be required to report into the office twice a month per ...
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · On-site +1
$67K/yr
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
Medical & Disability Nurse Case Manager
Lake Oswego, OR · On-site +1
$67K/yr
This is a remote position however, you will be required to report into the office twice a month per ... Documents all RN activities accurately, concisely and on a timely basis. This includes documenting ...
If you are a registered nurse licensed in the state of Oregon or are willing to obtain your Oregon ... Location: Remote: This position has the possibility of being 100% remote. About Us: Yamhill ...
If you are a registered nurse licensed in the state of Oregon or are willing to obtain your Oregon ... Location: Remote: This position has the possibility of being 100% remote. About Us: Yamhill ...
If you are a registered nurse licensed in the state of Oregon or are willing to obtain your Oregon ... Location: Remote: This position has the possibility of being 100% remote. About Us: Yamhill ...
If you are a registered nurse licensed in the state of Oregon or are willing to obtain your Oregon ... Location: Remote: This position has the possibility of being 100% remote. About Us: Yamhill ...
REMOTE Utilization Review Nurse - Managed Care
Coos Bay, OR · Remote
$35.29 - $47.37/hr
Schedule: PART-TIME, 20-HRS/WEEK, GENERALLY MONDAY - FRIDAY, BUT MAY INCLUDE ADDITIONAL HOURS TO ... Unrestricted Oregon RN license * Experience with a similar population in health plans or managed ...
REMOTE Utilization Review Nurse - Managed Care
Coos Bay, OR · Remote
$35.29 - $47.37/hr
Schedule: PART-TIME, 20-HRS/WEEK, GENERALLY MONDAY - FRIDAY, BUT MAY INCLUDE ADDITIONAL HOURS TO ... Unrestricted Oregon RN license * Experience with a similar population in health plans or managed ...
Healthcare Recruiters
OR · Remote
$55K/yr
... seeking remote Healthcare Recruiters to manage a high volume of local contract orders. Currently, their pipeline is a diverse 50/50 split between Registered Nurses (RNs) and Allied Health ...
Quick apply
Healthcare Recruiters
OR · Remote
$55K/yr
... seeking remote Healthcare Recruiters to manage a high volume of local contract orders. Currently, their pipeline is a diverse 50/50 split between Registered Nurses (RNs) and Allied Health ...
Registered Nurses - AI Training - Portland, USA
Portland, OR · Remote
$65/hr
... per AI task completed. You must be prepared to complete paid tasks that require one hour of uninterrupted work , though many are shorter. What you'll bring * Verified status as a registered nurse (e ...
Quick apply
Registered Nurses - AI Training - Portland, USA
Portland, OR · Remote
$65/hr
... per AI task completed. You must be prepared to complete paid tasks that require one hour of uninterrupted work , though many are shorter. What you'll bring * Verified status as a registered nurse (e ...
Per Diem Remote Endoscopy Rn information
What is the difference between Per Diem Remote Endoscopy Rn vs Per Diem Gastroenterology Rn?
| Aspect | Per Diem Remote Endoscopy Rn | Per Diem Gastroenterology Rn |
|---|---|---|
| Certifications | RN license, GI/endoscopy certifications | RN license, GI/endoscopy certifications |
| Work Environment | Remote endoscopy procedures, telehealth support | In-clinic or hospital GI departments, procedures |
| Employer & Industry | Hospitals, outpatient clinics, telehealth companies | Hospitals, outpatient clinics, specialty practices |
Per Diem Remote Endoscopy Rns typically support endoscopy procedures remotely or in telehealth settings, focusing on patient prep and post-procedure care. Per Diem Gastroenterology Rns work directly in clinical environments assisting with procedures and patient care. Both roles require similar certifications but differ mainly in work setting and daily responsibilities.
Other
Posted 25 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