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Appeals Nurse Remote Jobs in Riverside, CA (NOW HIRING)

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...

All JobsAppeals Nurse JobsAppeals Nurse Remote JobsAppeals Nurse Remote Jobs in Riverside, CA

Appeals Nurse Remote information

See Riverside, CA salary details

$31.8K

$90.2K

$120.5K

How much do appeals nurse remote jobs pay per year?

As of Aug 25, 2026, the average yearly pay for appeals nurse remote in Riverside, CA is $90,222.00, according to ZipRecruiter salary data. Most workers in this role earn between $69,400.00 and $102,800.00 per year, depending on experience, location, and employer.

What is an appeals nurse remote?

An Appeals Nurse Remote is a registered nurse (RN) or licensed practical nurse (LPN) who reviews denied medical claims and appeals decisions made by insurance companies. They assess medical records, ensure proper documentation, and determine if the denial should be overturned based on clinical guidelines and payer policies. Working remotely, they collaborate with providers, patients, and insurance representatives to support fair and accurate claim decisions. Strong analytical skills, attention to detail, and knowledge of healthcare regulations are essential in this role.

What does an appeals nurse remote do?

A typical day for a remote Appeals Nurse involves reviewing denied insurance claims, analyzing patient medical records, and preparing detailed appeal letters to support the need for clinical services. You’ll collaborate electronically with physicians, case managers, and insurance representatives, often attending virtual meetings to discuss case outcomes. Balancing independent focused work with virtual team communication is common. In addition, staying current with evolving healthcare regulations and payer policies is an important ongoing responsibility. This role offers a blend of analytical work and healthcare advocacy, all performed in a remote environment.

What are the key skills and qualifications for an appeals nurse remote?

To thrive as an Appeals Nurse Remote, you need an active RN license, strong clinical knowledge, and experience with utilization review or case management. Familiarity with medical review systems, insurance portals, and secure electronic documentation tools is typically required. Excellent written communication, analytical thinking, and attention to detail are standout soft skills for this role. These abilities ensure accurate, timely appeals processes and support fair, compliant healthcare coverage decisions.

What are popular job titles related to Appeals Nurse Remote jobs in Riverside, CA?

For Appeals Nurse Remote jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Appeals Nurse Remote jobs in Riverside, CA look for?

The top searched job categories for Appeals Nurse Remote jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Appeals Nurse Remote jobs?

Cities near Riverside, CA with the most Appeals Nurse Remote job openings:

Appeals Nurse Remote jobs near you
Infographic showing various Appeals Nurse Remote job openings in Riverside, CA as of August 2026, with employment types broken down into 3% As Needed, 58% Full Time, 17% Part Time, and 22% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $90,222 per year, or $43.4 per hour.

Physician Internal Medicine - Competitive Salary

Pomona, CA • Remote

Inspire Healthcare
Recruiting and Staffing Services • 11 - 50 employees
Learn more about Inspire Healthcareexternal

$250K - $350K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the LAarea and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

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About Inspire Healthcare

Sourced by ZipRecruiter

Inspire Healthcare, based in Boynton Beach, FL, US, is a dynamic firm in the healthcare staffing industry. Established with the dedication to provide a quality recruitment service to the healthcare sector, it is dedicated to assisting healthcare providers with their staffing needs. Its official website, ihcrecruiting.com, presents a comprehensive portfolio of services that cater to diverse healthcare facilities and positions. Its mission is firmly rooted in delivering professional healthcare staffing services that fulfill clients' needs efficiently and effectively, while also creating prosperous opportunities for healthcare professionals. A notable achievement of the company is its breadth of service, extending its recruiting coverage all across the country.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Boynton Beach, FL, US

Social media

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