Role Description We are hiring contract-based Mathematics Quality Reviewers who will be responsible for ensuring quality standards are met by reviewing, applying feedback, and supporting design for Australian Mathematics lessons hosted on the Education Perfect (EP) learning platform. The project will commence in late July and continue until December. We require a commitment of approximately 15 hours per week, with flexibility to accommodate your schedule. Employment will be contract-based and payment will be based on deliverable item. What you will do - Peer-checking and quality reviewing curriculum-aligned lessons to ensure quality standards are met on all tasks - Checking mathematical accuracy and applying feedback as required - Support design, build and quality-check interactive lesson elements as required - Managing your project tasks and time via online tools and software Qualifications - Relevant experience in editing, reviewing, publishing or digital content creation - Proven subject-matter expertise in Mathematics - Experience with mathematical equation writing (LaTeX or similar) - Experience in instructional design or a background in educational content development - Excellent time management skills and the ability to work independently - Strong attention to detail to ensure our instructional design standards are reached Benefits - Flexible working hours - Ability to work from home - Comprehensive training and ongoing support from our fantastic Education Perfect Content Team

• Support most complex medical record audit programs • Generate concise in-depth reporting and analysis to track performance • Provide Provider Pre Pay production and progress reports • Recommend process or procedure changes • Demonstrate leadership ability • Identify knowledge gaps and provide training opportunities • Serve as a primary resource for provider escalation support • Maintain a working knowledge of all state and federal laws, rules, and billing guidelines

Role Description Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. The West Virginia University Health System, the state’s largest health system and largest private employer, comprises 18 hospitals throughout the state and bordering states. In addition, it includes five institutes, as well as providing management services for other local hospitals through affiliate agreements. Whether you are caring for our patients at one of the critical access hospitals, community sites, regional or academic medical centers, we are all one WVU Health System. Work Here. Thrive Here. Qualifications - Scheduled Weekly Hours: 0 - Shift: Exempt/Non-Exempt - Location: United States of America (Exempt) - Company: SMG System Medical Group - Cost Center: 7994 SMG Teleradiology Multi Locations Company Description The West Virginia University Health System is the state’s largest health system and largest private employer, comprising 18 hospitals throughout the state and bordering states. - Includes five institutes - Provides management services for other local hospitals through affiliate agreements

Role Description The Clinical Review Specialist provides clinical review support on a full-time basis to assist with an increase in inventory and client demand. This role is responsible for reviewing medical records for medical necessity, level of care, authorization compliance, and payer guideline alignment across inpatient and outpatient services. The position supports timely appeal submissions and inventory management while maintaining quality and compliance standards. Essential Duties and Responsibilities - Perform clinical reviews for medical necessity, level of care, and authorization-related denials - Review inpatient and outpatient medical records to support appeal submissions - Apply payer-specific guidelines (CMS, Medicaid, commercial) and internal policies - Identify documentation gaps and support clear, defensible clinical narratives - Meet assigned turnaround times while maintaining quality standards - Document review findings accurately in designated systems - Collaborate with clinical leadership as needed for escalations or complex cases Qualifications - Active, unrestricted RN license (compact preferred) - Minimum 4–5 years of clinical experience - 4+ years of Utilization Review, Appeals, or Clinical Review experience - Strong knowledge of medical necessity criteria and payer guidelines - Experience reviewing inpatient and/or outpatient hospital claims - Proficiency with EMRs and review platforms (Epic preferred) - Strong written clinical documentation and time management skills Preferred Qualifications - Experience with payer appeals (medical necessity, no-auth, readmissions) - Familiarity with InterQual, MCG, or payer-specific criteria - Prior remote clinical review experience - Multi-client or vendor-side experience - Knowledge of Medicare, Medicaid, and commercial payer processes Work Expectations - Remote, independent work with defined productivity expectations Performance Expectations - Timely completion of assigned reviews - Accurate application of clinical criteria and payer policy - Clear, compliant documentation - Ability to adapt to changing inventory and priorities Physical Demands Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.