Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... case of peer reviews. Provide ideas to management on continuous improvement and service level ...
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Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... case of peer reviews. Provide ideas to management on continuous improvement and service level ...
Quick apply
Claims Specialist with FineOS Remote Fulltime Responsibilities: To provide Absence case management ... case of peer reviews. Provide ideas to management on continuous improvement and service level ...
Cincinnati, OH ยท Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and case-level ...
Cincinnati, OH ยท Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and case-level ...
Cincinnati, OH ยท Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and case-level ...
Cincinnati, OH ยท Remote
$70 - $80/hr
Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and case-level ...
Participates in multidisciplinary team meetings and case reviews. * Maintains accurate and timely ... Remote flexibility with meaningful community engagement * Competitive salary based on experience ...
Participates in multidisciplinary team meetings and case reviews. * Maintains accurate and timely ... Remote flexibility with meaningful community engagement * Competitive salary based on experience ...
Cincinnati, OH ยท Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
Cincinnati, OH ยท Remote
$54K - $107K/yr
This role is remote however candidates must live in Ohio. This role is laser focused on Quality ... Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
Cincinnati, OH ยท Remote
$40K - $70K/yr
... reviewing of immigration forms and letters based on the analysis of case details, documents, and ... Contribute to positive team morale, even within a remote work environment. What you bring:
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Cincinnati, OH ยท Remote
$40K - $70K/yr
... reviewing of immigration forms and letters based on the analysis of case details, documents, and ... Contribute to positive team morale, even within a remote work environment. What you bring:
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
Cincinnati, OH ยท Remote
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
Cincinnati, OH ยท Remote
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
Cincinnati, OH ยท Remote
$106K - $134K/yr
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
Cincinnati, OH ยท Remote
$106K - $134K/yr
... case management referrals and patient/family counseling. * Plans patient care based on knowledge of ... record review by the respective delegating physician. * If supporting patients in Tennessee ...
Cincinnati, OH ยท Remote
$76.33/hr
... case management referrals and patient/family counseling. * Evaluates need for immediate nursing ... Valid, active Registered Nurse license required * Board certification by AANP or ANCC required
Cincinnati, OH ยท Remote
$76.33/hr
... case management referrals and patient/family counseling. * Evaluates need for immediate nursing ... Valid, active Registered Nurse license required * Board certification by AANP or ANCC required
Cincinnati, OH ยท Remote
$25 - $40/hr
Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario ... as registered nurses or licensed practical nurses. * Effective Teaching Methods: Ability to ...
Cincinnati, OH ยท Remote
$25 - $40/hr
Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario ... as registered nurses or licensed practical nurses. * Effective Teaching Methods: Ability to ...
Cincinnati, OH ยท Remote
$30 - $40/hr
Adapts instruction using board review materials, clinical case analysis, and practice examinations to support MSN and DNP graduates preparing for ANCC Family Nurse Practitioner certification.
Cincinnati, OH ยท Remote
$30 - $40/hr
Adapts instruction using board review materials, clinical case analysis, and practice examinations to support MSN and DNP graduates preparing for ANCC Family Nurse Practitioner certification.
Continuously review and improve ethics and compliance programs and their effectiveness to adapt to ... Provide oversight of the ethics reporting program, including hotline operations and case management.
New
Continuously review and improve ethics and compliance programs and their effectiveness to adapt to ... Provide oversight of the ethics reporting program, including hotline operations and case management.
New
Cincinnati, OH ยท Remote
$120K - $216K/yr
... level review. * Assessment of the claims and providing an analysis to the client and carrier ... Case Staffer. Qualifications: * Must be admitted to the CA state bar and comply with all ethical ...
Cincinnati, OH ยท Remote
$120K - $216K/yr
... level review. * Assessment of the claims and providing an analysis to the client and carrier ... Case Staffer. Qualifications: * Must be admitted to the CA state bar and comply with all ethical ...
Cincinnati, OH ยท Remote
$100K - $175K/yr
C., is to assist the assigned team in the review and filing of immigration casework. In this role ... case processing software * Contribute to positive team morale, even within a remote work ...
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Cincinnati, OH ยท Remote
$100K - $175K/yr
C., is to assist the assigned team in the review and filing of immigration casework. In this role ... case processing software * Contribute to positive team morale, even within a remote work ...
Cincinnati, OH ยท Remote
$115K - $200K/yr
C., is to assist the assigned team in the review and filing of immigration casework. In this role ... case processing software * Contribute to positive team morale, even within a remote work ...
Quick apply
Cincinnati, OH ยท Remote
$115K - $200K/yr
C., is to assist the assigned team in the review and filing of immigration casework. In this role ... case processing software * Contribute to positive team morale, even within a remote work ...
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Quick apply
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Quick apply
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Quick apply
Cincinnati, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Fairfield, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
Fairfield, OH ยท Remote
$1.8K - $11K/mo
... review and observe a member's current health, medical history, medication adherence, social ... Work with physicians, case managers, social workers, family members, key caregivers, and ancillary ...
$18.08 - $23.28
3% of jobs
$23.28 - $28.48
6% of jobs
$33.20 is the 25th percentile. Wages below this are outliers.
$28.48 - $33.68
17% of jobs
$33.68 - $38.88
20% of jobs
The median wage is $39.92 / hr.
$38.88 - $44.08
16% of jobs
$44.08 - $49.28
11% of jobs
$50.39 is the 75th percentile. Wages above this are outliers.
$49.28 - $54.48
7% of jobs
$54.48 - $59.68
6% of jobs
$59.68 - $64.88
5% of jobs
$64.88 - $70.08
4% of jobs
$70.08 - $75.28
3% of jobs
$18
$44
$75
| Aspect | Remote Rn Case Review | Remote Rn Utilization Review |
|---|---|---|
| Credentials | Registered Nurse (RN), licensure, case review certifications | Registered Nurse (RN), licensure, utilization review certifications |
| Work Environment | Remote, healthcare settings, insurance companies | Remote, healthcare settings, insurance companies |
| Employer & Industry | Hospitals, insurance firms, healthcare providers | Insurance companies, healthcare management organizations |
Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.
For Remote Rn Case Review jobs in Mason, OH, the most frequently searched job titles are:
The top searched job categories for Remote Rn Case Review jobs in Mason, OH are:
Cities near Mason, OH with the most Remote Rn Case Review job openings:

Full-time
PTO
Re-posted 15 hours ago
Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employer’s guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.