Reviewer

• Watch Johnny Chang's long-form streams and identify 8 to 12 clip-worthy moments per stream.
• Hand off selected moments with timestamps and topic tags.
• Review every edited clip before publication.
• Approve strong edits and return others with actionable, specific notes.
• Track clip performance, reach, hooks, watch-through, and hit rate using the dashboard.
• Use performance data to improve future clip selections.
• Keep the review queue moving and prevent strong cuts from waiting.
• Deliver tagged moments within 72 hours of each stream.
• Turn around every edit review within 48 hours.
• Select and explain one clip-worthy moment from a Johnny Chang livestream as part of the application.

Clip picker and video reviewer selecting high-performing short-form content for biblical media creator Johnny Chang

Clip Picker, Video Reviewer

Clip picker and video reviewer identifying high-performing short-form moments from Johnny Chang’s biblical content. Reviewing edits, tagging clips, and optimizing selections through performance data.

• Provide thorough, consistent, and independent examinations of grant applications using pre-established criteria
• Conduct reviews impartially, objectively, and without bias
• Evaluate proposals for value, quality, and likelihood of success
• Review applications concerning broadband deployment and adoption on Tribal Land
• Review programs promoting broadband access for remote learning, telework, or telehealth resources
• Work as part of a team to complete reviews efficiently and meet stringent deadlines
• Perform quality assurance practices and foster task completion and accuracy
• Attend all required trainings provided by the project team
• Be available to conduct reviews from mid-December 2026 through spring 2027
• Disclose conflicts of interest before conducting merit reviews
• Carry out Corner Alliance’s commitments to Deliver, Grow, and Thrive

Merit reviewer evaluating broadband grant applications for a government consulting client

Merit Grant Application Reviewer – Temporary

Merit Reviewer evaluating broadband grant applications for Corner Alliance’s federal government client. Assessing Tribal broadband, remote learning, telework, and telehealth proposals against established criteria.

• Coordinate, integrate, and monitor utilization of behavioral health or physical health services for members
• Perform pre-service, concurrent, and post-service clinical reviews to determine appropriateness and medical necessity of requested services
• Apply clinical review criteria, guidelines, medical policies, contractual benefits, and State and Federal Mandates
• Plan, implement, and document utilization management activities
• Obtain clinical information from members and providers and interact with treating physicians and other care providers
• Refer appropriate cases and potential quality-of-care or utilization issues to the Medical Director
• Collaborate with hospitals, home care, care management, and other providers to prevent gaps in care
• Act as a resource and liaison to the provider community
• Perform pricing, coding, and claims research when assigned
• Meet departmental timeliness, production, metrics, audit, regulatory, and accreditation requirements
• Assist with training and special projects
• Participate in rotating on-call schedules and work additional hours as needed
• Level II: suggest process improvements, mentor staff, manage complex assignments, and participate in committees
• Level III: provide leadership, resolve escalated issues, update procedures, mentor staff, support orientation and training, and provide supervisor backup

Utilization Management Reviewer assessing healthcare service necessity for Excellus BCBS members

Utilization Management Reviewer, RN

Utilization Management Reviewer assessing behavioral and physical healthcare service necessity for Excellus BCBS members. Coordinating clinical reviews, providers, care management, and regulatory compliance.

• The Coding Quality Reviewer shall report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the medical record documentation.
• Review of patient records will be conducted via facility EMR, scanning technology or other established method.
• All reviews will be entered daily into Guidehouse proprietary quality review tracking and trending software
• Respond to coder rebuttals in a timely manner (timeline defined in quality review policies and procedures).
• Perform any and all related job duties as assigned.

Coding Quality Reviewer responsible for reviewing medical record documentation and coding accuracy

IP Quality Reviewer

Coding Quality Reviewer at Guidehouse reviewing medical records and coding accuracy. Ensuring adherence to quality review policies utilizing ICD-10 and CPT coding systems.

• Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review
• Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy
• Responds to and ensures that all issues raised by the beneficiary, representative, supplier, and provider have been addressed
• Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures
• Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision
• Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures
• Participates in special projects and performs other duties as assigned

Medicare Appeals Reviewer I reviewing enrollment appeal and rebuttal cases

Medicare Appeals Reviewer I – Dispute Resolution Reviewer I

Medicare Appeals Reviewer I supports federal clients by reviewing Medicare enrollment appeal and rebuttal cases. Evaluating documentation and issuing independent determinations based on applicable laws and guidelines.

• Review inpatient claims imported into the DRG database, focusing on diagnosis, procedures, grouping logic, and reimbursement accuracy.
• Analyze weekly hospital billing files, identifying underpaid claims based on ICD-10 diagnosis and procedure codes.
• Conduct detailed medical record reviews post-bill to determine if submitted diagnosis and procedure codes are accurate and complete.
• Navigate medical records efficiently, targeting specific sections (e.g., discharge summary, operative reports) based on system edits and flagged items.
• Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG accuracy.
• Identify and correct errors such as under coded or misclassified diagnoses and procedures.
• Utilize Health ROI system edits to detect specific high-value opportunities (e.g., dialysis, occlusion, embolization, catheterization).
• Make reimbursement improvement recommendations and submit findings for client review and approval.
• Collaborate with leadership on case prioritization and workflow management.
• Stay informed on coding updates, payer guidelines, and DRG changes to support accurate recommendations.
• Analyze client reporting.
• Identify new revenue opportunities related to all inpatient DRG related components.

DRG Validator/Reviewer analyzing inpatient claims for reimbursement accuracy.

DRG Validator/Reviewer

DRG Validator/Reviewer responsible for reviewing post-billed inpatient claims for missed reimbursement opportunities. Utilizes ICD-10 coding expertise to optimize hospital reimbursement while ensuring compliance.

• Review and improve realistic travel scenarios used to train AI travel assistants.
• Think like a real trip planner and assess what makes a travel situation real, feasible, and decision-changing.
• Upgrade weak scenarios to effectively test the model.

Travel Expert reviewing realistic travel scenarios for AI training

Travel Expert, Reviewer

Travel Expert at Vetto reviewing realistic travel scenarios and enhancing them for AI training. Requires deep understanding of travel planning and feasibility assessment.

• Review and improve scenarios used to train AI teaching assistants.
• Think like a real educator to spot and upgrade weak scenarios.

Education Expert reviewing AI training scenarios for Vetto

Education Expert – Reviewer

Education Expert reviewing and improving scenarios for AI teaching assistants at Vetto. Engaging educators to upgrade weak scenarios and enhance learning interactions.

• Conduct onsite reviews of Ohio Medicaid provider locations throughout the state.
• Travel daily to provider sites and complete assigned review schedules.
• Execute ODM-approved site review checklists and conduct provider interviews in accordance with established protocols.
• Assess provider operations, documentation practices, and regulatory compliance requirements.
• Document site visit findings accurately, thoroughly, and professionally using proper grammar, punctuation, and objective observations.
• Submit completed reviews within established quality assurance and compliance deadlines.
• Analyze collected information and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
• Maintain strict confidentiality regarding provider information, findings, and review outcomes.
• Meet established productivity, quality, and customer service performance standards.
• Work independently while effectively managing priorities, deadlines, and travel schedules.
• Address provider questions and concerns professionally and identify opportunities for process improvement.
• Utilize technology, tablets, and reporting systems to document and complete reviews.
• Represent the organization professionally during all provider interactions.

Onsite Reviewer assessing Ohio Medicaid provider operations and compliance

Onsite Reviewer

Onsite Reviewer assessing and reviewing Ohio Medicaid providers for compliance and quality assurance. Conducting in-person evaluations and documenting findings for medicaid enrollment considerations.

• Travel daily to Medicaid provider locations throughout North Carolina.
• Conduct onsite reviews to verify provider operations, service delivery, and compliance requirements.
• Complete North Carolina Medicaid-approved site review checklists and conduct provider interviews according to established protocols.
• Observe, assess, and document provider practices, policies, and procedures.
• Prepare detailed, accurate, and professional reports documenting site visit findings.
• Submit all documentation within established quality assurance and compliance deadlines.
• Analyze information gathered during reviews and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
• Maintain strict confidentiality regarding provider information and site review findings.
• Meet established productivity, quality, and customer service standards.
• Independently manage travel schedules, workloads, timelines, and deadlines.
• Address provider concerns professionally and identify opportunities for process improvement.
• Evaluate provider documentation and operational practices to ensure compliance with North Carolina Medicaid requirements.
• Utilize tablets, Microsoft Office applications, and reporting systems to complete reviews and documentation.
• Represent SSO professionally during all provider interactions.

Onsite Reviewer conducting field-based Medicaid provider reviews in North Carolina

Onsite Reviewer conducting thorough Medicaid provider reviews across North Carolina. Ensuring compliance with Medicaid requirements through detailed assessments and reports.

• Determine the medical appropriateness of requested services by reviewing clinical information and applying evidenced-based guidelines
• Interact with providers, members, internal and external service teams to obtain necessary information and communicate determinations
• Conduct inpatient reviews to determine financial responsibility and processes requests within required timelines
• Collaborate with multidisciplinary teams to promote Banner Health's Integrated model
• Adhere to UM policies and procedures.

Remote RN Utilization Management Care Reviewer at Banner Health

RN Utilization Management Care Reviewer

Remote RN Utilization Management Care Reviewer at Banner Health determining medical appropriateness of services. Collaborating with care teams to optimize member outcomes and support safe transitions.

• Technical Reviewers play a pivotal role in evaluating the cybersecurity posture of enterprise environments across the Intelligence Community (IC).
• Conduct comprehensive technical assessments and manual audits of virtualized infrastructure platforms and network-attached storage (NAS) environments in Intelligence Community (IC) settings.
• Evaluate compliance with IC Directives, Security Technical Implementation Guides (STIGs), Security Requirement Guides (SRGs), and NIST 800-53 Rev 5 and 800-171 security controls relevant to virtualization and storage systems.
• Perform independent manual STIG checklist reviews for leading virtualization platforms including VMware ESXi, Microsoft Hyper-V, and KVM, as well as NAS/SAN devices such as NetApp and Dell EMC systems.
• Analyze risks and attack vectors associated with virtualized environments and storage architectures; assess controls including encryption, authentication, access management, and FIPS compliance.
• Provide technical recommendations and architectural guidance to improve virtual infrastructure security posture.
• Liaise with virtualization system administrators, storage teams, and leadership to communicate findings, risk assessments, and remediation strategies.
• Lead and mentor Level 1 IDRs in conducting IV&S inspections and risk analysis.
• Stay current with emerging virtualization and storage security threats, industry trends, and vendor hardening best practices.
• Participate in inspection planning, execution, reporting, and deliver clear, concise written and oral assessments.
• Travel as necessary to support onsite inspections. (8-12 weeks of travel avg, some international and passport required).

Technical Reviewer evaluating cybersecurity posture for enterprise environments

Senior Infrastructure Virtualization and Storage Technical Reviewer

Technical Reviewer evaluating cybersecurity posture across enterprise environments for the Intelligence Community. Conducting technical assessments and providing security architecture guidance with a focus on virtualization and storage systems.

• Performs review of a variety of routine and complex analytical analysis experiments
• Ensures analyses are following validated or experimental analytical procedures
• Reviews data entered into databases and reports and monitors the quality of the laboratory data
• Evaluates laboratory data for compliance with analytical methods, client directives, and SOPs
• Reviews sample results for scientific soundness, completeness, accurate representation of the data, and final reported results
• Communicates with laboratory staff to proactively maintain the quality of laboratory documentation
• Delivers review findings noting deficiencies within the analytical data or reports in a clear and concise manner

Data Reviewer ensuring compliance of analytical methods for pharmaceutical compounds

Data Reviewer – Cell Lab

Data Reviewer at Thermo Fisher Scientific ensuring compliance of analytical methods for pharmaceutical compounds. Performing complex data reviews and maintaining laboratory documentation for quality assurance.

• Performs review of a variety of routine and complex analytical analysis experiments
• Ensures analyses are following validated or experimental analytical procedures
• Reviews data entered into databases and reports and monitors the quality of the laboratory data
• Communicates with laboratory staff to proactively maintain the quality of laboratory documentation
• Identifies and supports process improvement initiatives

Data Reviewer ensuring GMP compliance for laboratory analyses

Data Reviewer – Biopharm

Data Reviewer at Thermo Fisher Scientific ensuring GMP compliance in laboratory analyses of pharmaceutical compounds and reporting quality assessments to improve health outcomes.

• Conduct quality reviews of field survey reports to assure technical and professional company quality standards are met prior to the work being released for transmittal to the customer.
• Ability to conduct quality reviews on all lines of business, with a strength in Property and the ability to evaluate automatic sprinkler protection adequacy.
• Provide detailed reviews of Farm Loss Control Reports, including building valuations.
• Provide prompt, clear, succinct guidance to field staff for correction of any work not attaining acceptance of company quality standards.
• Provide technical coaching and assistance to survey field staff.
• Accountable for the quality of all survey work released by the branch to its customers.
• Advise the Quality Director of findings, training needs, product improvements or other actions that will improve the product of the surveys completed for our customers.
• Prepare accurate professional documentation of survey review, and communicate clearly and professionally with field staff, team members and clients.
• When requested, actively and professionally participate in providing technical and other guidance to field staff, assist with preparation and delivery of various training, and effectively coach staff.
• May be requested to assist with the more complicated and challenging field surveys should additional time be available after completion of the primary task of survey review and feedback.

Loss Control Reviewer conducting quality assessments for insurance surveys.

Loss Control Reviewer – Part Time

Loss Control Reviewer assessing insurance surveys for quality and compliance. Providing detailed feedback and coaching to field survey staff remotely.

• Performs review of a variety of complex analytical analysis experiments that are conducted on pharmaceutical and biopharmaceutical compounds in various formulations and/or biological matrices
• Possess a thorough understanding of laboratory procedures and can reliably conduct routine, non-routine (method establishment), and complex analytical data review ensuring scientific soundness and adhering to method validation
• Ensures analyses are following validated or experimental analytical procedures, and compare results to methodology, protocol and product specifications, Standard Operating Procedures (SOPs) acceptance criteria, and Good Manufacturing Practices (GMP)
• Reviews data entered into databases and reports and monitors the quality and scientific soundness of the laboratory data
• Delivers review findings noting deficiencies within the analytical data or reports in a clear and concise manner
• Escalates significant deficiencies to the project leader or supervisor for assessment
• Trains new Data Reviewers and laboratory staff in basic and complex analytical data review
• Mentors junior data review staff in review process
• Advocates the departmental manager or supervisor in the evaluation of the laboratory Data Review process and assists in assigning work to self and others
• Identifies and drives process improvement initiatives

Sr Data Reviewer handling complex analytical data review in a fully remote GMP lab

Senior Data Reviewer – Small Molecule

Sr Data Reviewer managing complex analytical data review of pharmaceutical compounds in a fully remote GMP lab. Enhancing health outcomes through rigorous data management and team mentorship.

• Use rubrics and supplemental information to provide fair and consistent evaluations with encouraging, specific, and actionable feedback
• Maintain an in-depth knowledge of every component of curriculum within assigned workload
• Swiftly respond to student outreach and return evaluations to students within 48 hours of submission
• Work with Goal Lead to provide proactive outreach to students in need of academic assistance
• Participate in Reviewer online community
• Support academic integrity validation and processing potential violations
• Participate in quality assurance processes and project improvement activities, as needed

Reviewer evaluating student projects at Southern New Hampshire University

Reviewer responsible for evaluating student project submissions at Southern New Hampshire University. Provide actionable feedback and ensure academic integrity in evaluations.

• Provide timely review and determination of medical claims, including prior authorization, appeals, and/or any other type of medical claims;
• Analyze medical records related to the case file;
• Review and interpret Local Coverage Determination (LCD), National Coverage Determination (NCD) policies, and other federal regulations;
• Apply appropriate regulatory citations, including health plan policies, NCD/LCDs, and/or other regulations to each claim as it relates to the item or issue;
• Formulate a narrative decision citing relevant regulatory back-up documentation contained within the medical record;
• Adjudicate claim based on the regulations and documentation contained within the medical record;
• Attend FHAS and/or client Lunch & Learn sessions and/or general training sessions on site as needed.
• Complete IRR surveys in a timely fashion as required by the prime contractor Maintain a 97% or higher quality score work experience requirements

Nurse Reviewer RN providing timely review and determination of medical claims

Nurse Reviewer, RN

Nurse Reviewer RN providing timely review and determination of medical claims for a healthcare provider. Analyzing records and adjudicating claims based on federal regulations and policies.

• Supports successful completion and submission of the MDS (Minimum Data Set) to MassHealth
• Examines MDS assessments prepared by clinicians to ensure completeness, accuracy and appropriate explanation of functional status and related clinical findings
• Provides feedback to Clinical Care Manager to facilitate optimal documentation and, where necessary, rating category assignment
• Supports the Proxy MDS Reviewer (LPN) in completing Proxy MDS submissions for members who cannot be reached for assessment
• Completes portions of the electronic MDS-HC form based on diagnoses/information gathered from record review
• Prepares printed MDS forms for data entry
• Conducts routine training sessions for new Care Management staff and relevant Clinical Care Manager to drive high quality, consistent MDS assessments
• Conducts reviews in a timely way in accordance with all timeliness and quality standards
• Provides clinical care to members via telehealth technologies (video, chat, etc.)

RN MDS Reviewer ensuring accurate MDS submission to MassHealth

RN MDS Reviewer

RN MDS Reviewer ensuring accuracy of MDS assessments and completion for submission to MassHealth. Collaborating with clinical teams for optimal documentation and rating assignment in a remote capacity.

• conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines
• collaborating with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits
• working on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management
• partnering with more senior colleagues to complete non-routine reviews
• conducting medical necessity clinical screenings of preauthorization requests to assess the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment

Nurse Reviewer 1 conducting preauthorization reviews for diagnostic imaging services

Nurse Reviewer

Nurse Reviewer 1 responsible for conducting preauthorization reviews for diagnostic imaging services. Collaborating with healthcare providers to ensure quality member outcomes and optimize benefits.

Reviewer jobs in United States

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Clip Picker, Video Reviewer

Merit Grant Application Reviewer – Temporary

Utilization Management Reviewer, RN

IP Quality Reviewer

Medicare Appeals Reviewer I – Dispute Resolution Reviewer I

DRG Validator/Reviewer

Travel Expert, Reviewer

Education Expert – Reviewer

Onsite Reviewer

Onsite Reviewer

RN Utilization Management Care Reviewer

Senior Infrastructure Virtualization and Storage Technical Reviewer

Data Reviewer – Cell Lab

Data Reviewer – Biopharm

Loss Control Reviewer – Part Time

Senior Data Reviewer – Small Molecule

Reviewer

Nurse Reviewer, RN

RN MDS Reviewer

Nurse Reviewer