This role involves conducting pre- and post-payment medical reviews to ensure compliance with ... Active compact multistate RN license (as defined by the Nurse Licensure Compact). Education:
This role involves conducting pre- and post-payment medical reviews to ensure compliance with ... Active compact multistate RN license (as defined by the Nurse Licensure Compact). Education:
The recruiter will own the full life cycle - intake, sourcing, screening, scheduling, offers, pre ... remote work, and alignment with MOBE values. Coordinate interview loops with RN Managers and ...
The recruiter will own the full life cycle - intake, sourcing, screening, scheduling, offers, pre ... remote work, and alignment with MOBE values. Coordinate interview loops with RN Managers and ...
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Support testing for system updates and implementations as assigned. * May help train new staff and ... Review provider pre-service requests and determine benefit coverage according to Medicare, Medicaid ...
Support testing for system updates and implementations as assigned. * May help train new staff and ... Review provider pre-service requests and determine benefit coverage according to Medicare, Medicaid ...
Support testing for system updates and implementations as assigned. * May help train new staff and ... Review provider pre-service requests and determine benefit coverage according to Medicare, Medicaid ...
Support testing for system updates and implementations as assigned. * May help train new staff and ... Review provider pre-service requests and determine benefit coverage according to Medicare, Medicaid ...
Travel Home Health Registered Nurse - $2,889 per week
Portland, OR · Remote
$2.89K/wk
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Travel Home Health Registered Nurse - $2,889 per week
Portland, OR · Remote
$2.89K/wk
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Travel Home Health Registered Nurse - $2,889 per week
Portland, OR · Remote
$2.89K/wk
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Travel Home Health Registered Nurse - $2,889 per week
Portland, OR · Remote
$2.89K/wk
Prime Time Healthcare Nursing is seeking a travel nurse RN Home Health for a travel nursing job in ... EPIC Remote Client for Home Health (on laptop) and Rover (phone app)/ Oasis About Prime Time Health ...
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... Nurse (RN) to join our Medical Review team . This role involves conducting pre- and post-payment ...
Medical Claim Reviewer (CGS, DMEC)
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... Nurse (RN) to join our Medical Review team . This role involves conducting pre- and post-payment ...
NCLEX-RN Tutor
Portland, OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
NCLEX-RN Tutor
Portland, OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
NCLEX-RN Tutor
OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
NCLEX-RN Tutor
OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
NCLEX-RN Tutor
Eugene, OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
NCLEX-RN Tutor
Eugene, OR · Remote
$40/hr
Ability to explain clinical judgment measurement model, computerized adaptive testing, and Next Generation item types while preparing registered nursing graduates for licensure. * Strategic Test ...
Registered Nurse / Wound Care (Tier 3) / VA Reviewer - Remote (#25276) Location ... Remote Employment Type: Contract (Case-based) Hourly Rate: Per Case Compensation (See details below ...
Registered Nurse / Wound Care (Tier 3) / VA Reviewer - Remote (#25276) Location ... Remote Employment Type: Contract (Case-based) Hourly Rate: Per Case Compensation (See details below ...
Remote Care Management Nurse
Bend, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Bend, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Salem, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Salem, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Medford, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Medford, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Portland, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Remote Care Management Nurse
Portland, OR · Remote
$34.20 - $55.70/hr
Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho ... Are you a Registered Nurse looking to transition out of bedside care and into a role that still ...
Appeals RN (Temporary)
$50/hr
Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ... Candidates may be required to go through a pre-employment criminal background check. HealthEdge is ...
Appeals RN (Temporary)
$50/hr
Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ... Candidates may be required to go through a pre-employment criminal background check. HealthEdge is ...
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 ...
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 Pre Anesthesia Testing Rn information
What are the key skills and qualifications needed to thrive as a Remote Pre Anesthesia Testing RN, and why are they important?
What are the main challenges faced by a Remote Pre Anesthesia Testing RN, and how can they be addressed?
What are Remote Pre Anesthesia Testing RNs?
What is the difference between Remote Pre Anesthesia Testing Rn vs Preoperative Nurse?
| Aspect | Remote Pre Anesthesia Testing Rn | Preoperative Nurse |
|---|---|---|
| Certifications | RN license, anesthesia testing training | RN license, preoperative care training |
| Work Environment | Remote, telehealth setting | Hospital, clinic, surgical center |
| Employer & Industry | Healthcare providers, telehealth companies | Hospitals, surgical facilities |
Remote Pre Anesthesia Testing Rns focus on preoperative assessments via telehealth, while Preoperative Nurses work directly in clinical settings. Both roles require RN licensure and involve patient evaluations, but their work environments and daily tasks differ significantly.

Other
Posted 11 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