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Greenlife Healthcare Staffing

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Clinical Reviewer Registered Nurse

Jericho, NY · On-site

$60/hr

RN Clinical Reviewer - Jericho or Albany, NY (#25332) * Location: Jericho orAlbany, NY * Employment ... Health Insurance subject to plan eligibility requirements * Work Schedule: Full-time position, 5 ...

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Clinical Insurance Reviewer information

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How much do clinical insurance reviewer jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for clinical insurance reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

What is a clinical insurance reviewer?

A Clinical Insurance Reviewer evaluates medical claims to ensure they meet insurance policies and clinical guidelines. They review patient records, verify medical necessity, and determine coverage eligibility. This role requires knowledge of medical terminology, coding, and insurance regulations. Clinical Insurance Reviewers help prevent fraud, ensure compliance, and support fair reimbursement for healthcare providers and patients.

What are the key skills and qualifications needed to thrive as a clinical insurance reviewer?

To thrive as a Clinical Insurance Reviewer, you need a solid understanding of clinical practices, medical terminology, and insurance guidelines, often supported by a background in nursing or other healthcare professions. Familiarity with electronic medical records (EMRs), claims management systems, and utilization review software is highly valuable, and certifications such as Certified Professional in Healthcare Quality (CPHQ) can be advantageous. Strong analytical thinking, attention to detail, and effective communication skills set top performers apart in this role. These skills are crucial for accurately evaluating medical claims, ensuring compliance, and facilitating clear communication between healthcare providers and insurance companies.

What are the typical daily responsibilities of a clinical insurance reviewer?

Clinical Insurance Reviewers spend much of their day reviewing medical records and patient documentation to determine the medical necessity and appropriateness of treatments for insurance coverage. They assess claims against clinical guidelines, communicate their findings with healthcare providers or case managers, and may also participate in peer-to-peer reviews or appeals. Most positions involve working closely with other reviewers, physicians, and administrative staff, either remotely or in a collaborative office setting. This role requires strong organizational skills as well as the ability to manage multiple case reviews and deadlines simultaneously.

More about Clinical Insurance Reviewer jobs
What cities are hiring for Clinical Insurance Reviewer jobs? Cities with the most Clinical Insurance Reviewer job openings:
What are the most commonly searched types of Clinical Insurance Reviewer jobs? The most popular types of Clinical Insurance Reviewer jobs are:
What states have the most Clinical Insurance Reviewer jobs? States with the most job openings for Clinical Insurance Reviewer jobs include:
What job categories do people searching Clinical Insurance Reviewer jobs look for? The top searched job categories for Clinical Insurance Reviewer jobs are:
Clinical Insurance Reviewer jobs near you
Infographic showing various Clinical Insurance Reviewer job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $74,707 per year, or $35.9 per hour.

RN Clinical Reviewer

Greenlife Healthcare Staffing

Albany, NY • On-site

$60/hr

Full-time

Medical

Re-posted 5 days ago

Job description

RN Clinical Reviewer – Jericho or Albany, NY

Location: Jericho or Albany, NY
Employment Type: Full-time (5 days/week)
Rate: $60/hour

Position Overview:
We are seeking a meticulous Clinical Reviewer Registered Nurse. Working under the direction of the team supervisor, this individual performs clinical reviews and abstractions of assigned cases related to a maternal death or to an adverse event that occurred during an outpatient surgical procedure. This role is ideal for an experienced RN with a strong OB/maternal health background and a passion for quality improvement and patient safety.

Why You'll Love Working Here:
  • Competitive rate of $60/hour.
  • 5 sick days (40 hours), subject to the provisions of the NYS Paid Sick Leave Act.
  • Health insurance, subject to plan eligibility requirements.
  • Full-time, 5 days per week.
  • Valuable experience conducting high-stakes clinical reviews for the NYS Department of Health, enhancing your expertise in quality improvement and maternal health.
  • Mission-driven work identifying and analyzing critical events in maternal care and outpatient surgical procedures.

Qualifications:
  • Baccalaureate degree in Nursing, or graduate of an approved Registered Professional Nurses training program.
  • Current licensure as a registered professional nurse in New York State.
  • Minimum of four years of clinical practice experience in a facility or community-based setting, including medical, surgical, and/or obstetrical experience.
  • Minimum of two years of acute care hospital experience.
  • Experience in an acute or ambulatory care facility reviewing charts for quality improvement or utilization review, preferred.
  • Knowledge of current disease/care management/coordination trends, preferred.
  • Must have OB/maternal health background.
  • Strong analytical and communication (written and verbal) skills.
  • Ability to work independently and in a team environment.
  • Ability to prioritize reviews and projects.
  • Proficient in standard office technology and basic Microsoft applications including Word and Excel.
  • Ability to gather and analyze information from records, reports, and other sources.

Key Responsibilities:
  • Conduct clinical reviews of medical records from a variety of sources, as well as other documents crucial to the review.
  • Develop and draft narrative summaries of clinical reviews in the form(s) required by the NYS Department of Health.
  • Track case status in Excel and other databases as required.
  • Other activities as needed in response to the changing needs of the department.

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About Greenlife Healthcare Staffing

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Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

New York, NY, US

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