This page tracks remote reviewer openings that are location-eligible for Kentucky.
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$60 - $100,000
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12 Jobs
12 Companies
Transforming the health of the communities we serve, one person at a time.
• Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. • Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. • Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable laws, payer contracts, and organizational policies. • Independently conducts comprehensive MS-DRG and APR-DRG coding and clinical validation reviews, exercising professional judgment to verify ICD-10-CM/PCS assignments, validate clinical diagnoses, identify discrepancies, and apply inpatient reimbursement rules without direct supervision. • Collaborates with the Medical Director on complex cases, providing expert recommendations and influencing review outcomes to ensure clinical accuracy and compliance. • Leads the evaluation of complex cases and proactively identifies opportunities to develop medical policy in the absence of established guidelines, demonstrating discretion and authority in decision-making. • Applies advanced knowledge of coding guidelines and clinical policies throughout the review process, making autonomous determinations regarding coding accuracy and regulatory compliance. • Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, approved Centene policies, and adopted clinical guidelines, ensuring recommendations reflect professional expertise. • Evaluates claims and medical records for compliance with state and federal regulations, payer contracts, and company policies, exercising independent judgment in interpreting requirements and resolving ambiguities. • Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously. • Contributes to strategic initiatives by assisting in the development of audit concepts, identifying new audit opportunities, and selecting claims for review, demonstrating leadership in shaping audit methodologies. • Performs other duties as assigned. Complies with all policies and standards.
• Conduct comprehensive accessibility reviews of electronic documents, web applications, software interfaces, forms, reports, and other digital content to ensure compliance with Section 508 requirements • Evaluate content against applicable accessibility standards, including Section 508, WCAG, and related federal accessibility requirements • Perform manual and automated accessibility testing using industry-standard tools and assistive technologies • Review Microsoft Office documents, PDF files, web content, and other electronic deliverables for accessibility compliance • Document accessibility findings, deficiencies, risks, and recommendations in accordance with established review procedures and reporting standards • Prepare accessibility assessment reports, compliance documentation, review artifacts, and technical recommendations for project stakeholders • Provide remediation guidance and technical recommendations to developers, content authors, designers, and project teams • Research and interpret accessibility requirements, policies, standards, and best practices to support project implementation efforts • Develop, maintain, and update accessibility review documentation, procedures, checklists, job aids, and related technical materials • Track accessibility review activities, findings, corrective actions, and status updates using project management and issue-tracking tools • Collaborate with project teams to resolve accessibility issues and support successful remediation efforts • Support accessibility compliance reporting, audit preparation activities, and quality assurance reviews • Provide guidance and mentoring to junior staff and project team members regarding accessibility requirements and best practices • Participate in project meetings, requirements reviews, design discussions, and testing activities to ensure accessibility considerations are incorporated throughout the project lifecycle • Support continuous improvement initiatives related to accessibility processes, standards, and compliance monitoring • Ensure compliance with federal accessibility, security, privacy, and documentation requirements
• Review CNA reports for compliance with HUD requirements and industry standards prior to delivery to the client; accountable for QA/QC responsibilities • Evaluate technical accuracy and completeness of building component assessments • Verify cost estimates and replacement reserve analyses • Review property condition descriptions and immediate repair recommendations • Ensure proper use of HUD's CNA e-Tool • Validate remaining useful life calculations for building components • Review photo documentation and supporting materials • Provide feedback and correction requests to CNA preparers • Track review status and meet project deadlines • Achieve billing goals, which may vary depending on project complexity • Training and mentoring staff on inspection and workflow practices • Build direct client relationships in support of sales efforts through servicing the account • Serve as the Project Lead, ensuring all projects are staffed, performed to high standards of quality, and delivered on time • Manage projects being completed by consultants / 1099 Contractors • Ensure projects meet the client's goals and scope expectations
• Conduct independent, evidence-based file reviews. • Review patient records and related documentation in alignment with clinical guidelines. • Provide objective, high-quality reports within turnaround timelines. • Maintain compliance with URAC, HIPAA, and internal quality standards.
National Leader of Disability and Medical Review Services.
• Conduct comprehensive and objective medical chart reviews with honesty and integrity. • Produce determinations that are clear, concise, and well-supported by evidence. • Follow MMRO’s review templates, ensuring all required elements are complete and accurate. • Communicate findings in a professional manner using appropriate language and grammar. • Complete assigned reviews within the specified deadlines. • Respond promptly to communications from MMRO staff. • Review and comply with corporate training materials and review standards. • Be receptive to constructive feedback from MMRO’s Medical Director, Associate Medical Director, and Clinical Staff. • Contribute ideas for process improvement and quality enhancement.
• Prospectively review all OASIS assessments to ensure appropriateness, completeness, and regulatory compliance. • Evaluate OASIS data for internal consistency, accuracy, and alignment with patient condition and care delivery. • Utilize OASIS variation, validation, or alert reports to identify potential data integrity concerns. • Ensure documentation supports accurate clinical representation and compliant reimbursement. • Partner with clinicians and agency staff to clarify documentation discrepancies or data integrity issues. • Provide guidance to clinicians on appropriate corrections in accordance with agency policy and regulatory standards. • Support education and reinforcement of best practices related to OASIS completion and assessment accuracy. • Review visit utilization for alignment with patient condition, plan of care, and clinical guidelines. • Identify and report potential underutilization, overutilization, or financial risk to the Coding and OASIS Manager, Clinical Manager, or designee. • Escalate trends that may impact reimbursement, outcomes, or compliance. • Identify and communicate problematic trends or recurring issues identified through OASIS review. • Participate in Quality Improvement and Corporate Compliance initiatives as assigned. • Assist with additional chart audits or documentation reviews as needed. • Maintain current knowledge of OASIS standards, regulatory changes, and industry best practices. • Demonstrate and uphold CAPLICO values in all interactions and work practices.
• Testing online casino registration processes and user journeys • Reviewing sign-up flows, KYC requirements, deposit methods, and bonus activation • Evaluating platform usability, features, and overall user experience • Producing clear, well-structured reviews and editorial content in alignment with standardized templates and guidelines • Ensuring all content aligns with responsible gambling and regulatory guidelines • Documenting findings accurately and submitting deliverables on time • Representing Signup Expert and our publishing partners professionally
• Review AI-generated video outputs for sharpness, clarity, detail retention, and overall visual fidelity. • Identify compression artifacts, aliasing, noise patterns, ringing, temporal inconsistencies, and other quality defects. • Conduct frame-by-frame analysis to assess image integrity and consistency. • Help establish quality benchmarks and review criteria for video enhancement and super-resolution models. • Identify the visual characteristics that most strongly influence perceived quality and realism. • Curate examples of both high-quality and challenging visual content for model evaluation. • Assist in developing standardized reference sets for testing and comparison. • Translate complex visual observations into clear, actionable feedback and evaluation documentation. • Contribute to annotation frameworks, reviewer guidelines, and quality assessment rubrics. • Work alongside AI researchers, engineers, and creative professionals to improve model evaluation methodologies.
For over 130 years we provide complete surveying and civil engineering services across the U.S.
• Write & review Environmental Site Assessment (ESA) assignments. • Provide solid recommendations and solutions to Managing Directors and clients while understanding the assessment’s potential impact on the transaction process. • Oversee quality control throughout the project’s life cycle. • Manage field technician during site visits and occasionally lead fieldwork activities as necessary. • Complete research (historical, regulatory, etc.). • Communicate with client and subject site representatives. • Conduct appropriate site reconnaissance. • Data compilation and organization. • Prepare quality supporting documentation (site figures, appendices, etc.). • Other tasks as assigned by the Managing Director, associated with the report deliverable schedule and plan.
National Provider of IME and Medical Peer Review Services
• Evaluate and review disability claims from home • Work with a panel of independent physicians • Maintain flexibility in scheduling and workload
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