Clinical Review Nurse
Lake Mary, FL · On-site
Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines * Assist clinical staff in quality improvement ...
Clinical Review Nurse
Lake Mary, FL · On-site
Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines * Assist clinical staff in quality improvement ...
Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines * Assist clinical staff in quality improvement ...
Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines * Assist clinical staff in quality improvement ...
Utilization Review Assistant documents all updates on authorizations in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials ...
Utilization Review Assistant documents all updates on authorizations in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials ...
Summary The Clinical Review Manager (CRM) is responsible for the clinical review, approval, and ... delivery. * Assist with resolution of clinical documentation issues impacting patient care or ...
New
Quick apply
Summary The Clinical Review Manager (CRM) is responsible for the clinical review, approval, and ... delivery. * Assist with resolution of clinical documentation issues impacting patient care or ...
New
Clinical Review Specialist
Washington, DC · On-site
$45 - $50/hr
This position is responsible for maintaining proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims including ...
Quick apply
Clinical Review Specialist
Washington, DC · On-site
$45 - $50/hr
This position is responsible for maintaining proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims including ...
Utilization Review Assistant documents all updates on authorizations in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials ...
Quick apply
Utilization Review Assistant documents all updates on authorizations in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials ...
Clinical Review Specialist (31389)
Southlake, TX · On-site
$65K - $90K/yr
Completes Letters of Medical Necessity or other required clinical documents to assist with the intake and appeal process * Completes all reviews within department established policies and best ...
Clinical Review Specialist (31389)
Southlake, TX · On-site
$65K - $90K/yr
Completes Letters of Medical Necessity or other required clinical documents to assist with the intake and appeal process * Completes all reviews within department established policies and best ...
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Quick apply
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · On-site
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · On-site
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Pharmacy Clinical Review Specialist, Rx Partners
Bridgeville, PA · On-site
$120K - $140K/yr
Manage the first line clinical review of prior authorization requests for Community Provider ... Participates in the monthly billing process and assist with collection of delinquent accounts.
Pharmacy Clinical Review Specialist, Rx Partners
Bridgeville, PA · On-site
$120K - $140K/yr
Manage the first line clinical review of prior authorization requests for Community Provider ... Participates in the monthly billing process and assist with collection of delinquent accounts.
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · Remote
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · On-site
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Clinical Review Auditor I
Fort Worth, TX · On-site
$70K - $107K/yr
The Clinical Auditor will review medical records to determine accuracy of billing through ... Working knowledge of HIPAA Privacy and Security Rules * Assist Quality Control team and medical ...
Pharmacy Clinical Review Specialist, Rx Partners
Bridgeville, PA · On-site
$20.20 - $32.01/hr
Manage the first line clinical review of prior authorization requests for Community Provider ... Participates in the monthly billing process and assist with collection of delinquent accounts.
Pharmacy Clinical Review Specialist, Rx Partners
Bridgeville, PA · On-site
$20.20 - $32.01/hr
Manage the first line clinical review of prior authorization requests for Community Provider ... Participates in the monthly billing process and assist with collection of delinquent accounts.
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review RN PRN
$37 - $61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review RN PRN
$37 - $61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review RN PRN
Camden, NJ · On-site
$61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review RN PRN
Camden, NJ · On-site
$61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
$38 - $41/hr
... review of medical records specific to quality complaints/grievances and appeals as indicated in ... Ability to research and assist clinical team in rendering coverage determinations in accordance ...
$38 - $41/hr
... review of medical records specific to quality complaints/grievances and appeals as indicated in ... Ability to research and assist clinical team in rendering coverage determinations in accordance ...
Clinical Reviewer
Buffalo, NY · On-site
$38 - $41/hr
... review of medical records specific to quality complaints/grievances and appeals as indicated in ... Ability to research and assist clinical team in rendering coverage determinations in accordance ...
Clinical Reviewer
Buffalo, NY · On-site
$38 - $41/hr
... review of medical records specific to quality complaints/grievances and appeals as indicated in ... Ability to research and assist clinical team in rendering coverage determinations in accordance ...
Clinical Review RN PRN
Camden, NJ · On-site
$61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review RN PRN
Camden, NJ · On-site
$61/hr
Utilizes Payer specific screening tools as a resource to assist in the determination process ... review preferred. Knowledge and understanding of disease protocols and clinical pathways for ...
Clinical Review Assistant information
See salary details
$11.54 - $13.11
1% of jobs
$13.11 - $14.69
5% of jobs
$14.69 - $16.26
15% of jobs
$16.57 is the 25th percentile. Wages below this are outliers.
$16.26 - $17.83
20% of jobs
The median wage is $18.86 / hr.
$17.83 - $19.41
14% of jobs
$19.41 - $20.98
13% of jobs
$20.98 - $22.55
7% of jobs
$22.60 is the 75th percentile. Wages above this are outliers.
$22.55 - $24.13
8% of jobs
$24.13 - $25.70
9% of jobs
$25.70 - $27.27
4% of jobs
$27.27 - $28.85
3% of jobs
$11
$20
$28
How much do clinical review assistant jobs pay per hour?
As of Jul 30, 2026, the average hourly pay for clinical review assistant in the United States is $20.23, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $23.32 per hour, depending on experience, location, and employer.
What cities are hiring for Clinical Review Assistant jobs? Cities with the most Clinical Review Assistant job openings:
What are the most commonly searched types of Clinical Review jobs? The most popular types of Clinical Review jobs are:
What states have the most Clinical Review Assistant jobs? States with the most job openings for Clinical Review Assistant jobs include:
Full-time
Re-posted 20 days ago
Job description
TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated individuals who want to be part of our mission and join our team!
As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical review for select procedures that require medical necessity authorization. We are seeking individuals who enjoy a challenge, have an ability to work independently and are capable of meeting deadlines. Previous utilization management experience is preferred. In addition to prior experience, the ideal candidate will have an extreme attention to detail, an ability to flourish in a fast-paced environment and advanced grammar, punctuation, and computer skills.
Responsibilities
Qualifications:
Salary:
RN- 62k-68k
LPN- 52k-58k
As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical review for select procedures that require medical necessity authorization. We are seeking individuals who enjoy a challenge, have an ability to work independently and are capable of meeting deadlines. Previous utilization management experience is preferred. In addition to prior experience, the ideal candidate will have an extreme attention to detail, an ability to flourish in a fast-paced environment and advanced grammar, punctuation, and computer skills.
Responsibilities
- Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines
- Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines
- Assist clinical staff in quality improvement projects to provide instructive feedback to clients and providers within scope of practice
- Resolve patient care issues by working one-on-one with community providers and staff to resolve issues in the determination process
- Provide information by responding to queries of physicians and their practice staff, sorting and distributing messages and documents, and preparing information for determinations
- Improve quality results by studying, evaluating procedures and processes and recommending changes, if needed
- Serves and protects the company by adhering to accreditation standards, professional standards, company policies and procedures, federal, state, and local requirements, and professional and licensing standards
Qualifications:
- Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) required
- Comprehensive knowledge of general nursing theory and practices
- Excellent customer service skills and phone etiquette
- Proficient computer skills, including typing and an ability to maneuver through various programs
- Previous Utilization Management experience preferred but not required
- Knowledge of musculoskeletal surgical procedures, cardiac procedures, pain management and/ or wound care is a plus
- Ability to multi-task and manage tasks to completion on a timely basis and in an organized fashion
- Ability to work collaboratively as part of a team
Salary:
RN- 62k-68k
LPN- 52k-58k
About TurningPoint Healthcare Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Lake Mary, FL, US
Year founded
2014