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Clinical Review Coordinator Remote Jobs (NOW HIRING)

Corvel

Itemization Review Coordinator

Fort Worth, TX · Remote

$24.30 - $36.30/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Monitor incoming and existing ... Through our clinical expertise and cost containment solutions, we are committed to accuracy and ...

CERiS

Itemization Review Coordinator

Fort Worth, TX · Remote

$24.30 - $36.30/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Monitor incoming and existing ... Through our clinical expertise and cost containment solutions, we are committed to accuracy and ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · Remote

$65K - $75K/yr

Performs clinical reviews according to the policies and procedures of HealthHelp within the ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

Comagine

Clinical Reviewer

In this role, you will review clinical documentation to determine medical necessity and ... This is a remote position based in Oregon and travel is required. Why Comagine Health? Comagine ...

WNS Global Services

Nurse - Clinical Review

Houston, TX · On-site +1

$65K - $75K/yr

... Performs clinical reviews according to the policies and procedures of HealthHelp within the ... Remote Benefits - Medical , Dental, & Vision. 401K plan Compensation Disclosure The base salary for ...

Cohere Health

Clinical Review & Correspondence RN

$31 - $35/hr

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role ... This is a 100% remote role, and requires robust internet speeds (above 50 megabytes/second ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting ... Coordinate with cross-functional teams such as case management, care coordination, and program ...

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Clinical Review Coordinator Remote information

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How much do clinical review coordinator remote jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for clinical review coordinator remote in the United States is $28.65, according to ZipRecruiter salary data. Most workers in this role earn between $20.67 and $34.13 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Clinical Review Coordinator (Remote), and why are they important?

To thrive as a Clinical Review Coordinator (Remote), you generally need a background in nursing or healthcare, clinical review experience, and relevant licensure such as an RN or LPN/LVN. Familiarity with utilization management software, electronic medical records (EMRs), and knowledge of regulatory guidelines like Medicare and Medicaid are typically required. Strong organizational skills, attention to detail, and effective communication are vital soft skills for this role. These abilities ensure accurate case evaluations, compliance with healthcare standards, and effective remote collaboration with healthcare teams.

What does a Clinical Review Coordinator do when working remotely?

A Clinical Review Coordinator working remotely is responsible for reviewing medical records, insurance claims, and clinical documentation to ensure that healthcare services meet established guidelines and regulatory requirements. They typically collaborate with healthcare providers, insurance companies, and patients to verify the necessity and appropriateness of medical treatments. Remote coordinators use secure systems to access records, make determinations based on clinical criteria, and document their findings efficiently. The role requires a strong understanding of medical terminology, regulatory standards, and excellent communication skills.

What is the difference between Clinical Review Coordinator Remote vs Clinical Reviewer?

AspectClinical Review Coordinator RemoteClinical Reviewer
CertificationsTypically requires healthcare-related certifications (e.g., RN, LPN)Often requires similar healthcare credentials, such as RN or medical license
Work EnvironmentRemote, home-based settingCan be remote or onsite, depending on employer
Industry UsageUsed in insurance, healthcare, and managed care companiesCommon in healthcare facilities, insurance, and clinical research
Job FocusCoordinating clinical reviews, managing case documentationPerforming clinical assessments, reviewing patient data

While both roles involve clinical review tasks and healthcare credentials, the Clinical Review Coordinator Remote primarily focuses on coordinating and managing review processes remotely, whereas the Clinical Reviewer often performs direct clinical assessments, which may be onsite or remote. The choice depends on the specific job responsibilities and work environment preferences.

What are the typical challenges faced by a Clinical Review Coordinator working remotely, and how can they be addressed?

As a remote Clinical Review Coordinator, common challenges include maintaining effective communication with healthcare teams, managing time efficiently across multiple case reviews, and ensuring secure access to sensitive patient information. Overcoming these challenges often involves utilizing secure collaboration tools, establishing regular virtual check-ins with colleagues, and staying organized with digital workflow management systems. Building strong relationships with both clinical and administrative staff remotely can also help ensure smooth coordination and timely case resolution.
More about Clinical Review Coordinator Remote jobs
What cities are hiring for Clinical Review Coordinator Remote jobs? Cities with the most Clinical Review Coordinator Remote job openings:
What states have the most Clinical Review Coordinator Remote jobs? States with the most job openings for Clinical Review Coordinator Remote jobs include:
What job categories do people searching Clinical Review Coordinator Remote jobs look for? The top searched job categories for Clinical Review Coordinator Remote jobs are:
Clinical Review Coordinator Remote jobs near you
Infographic showing various Clinical Review Coordinator Remote job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 73% Full Time, 17% Part Time, and 8% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $59,597 per year, or $28.7 per hour.

Clinical Review Nurse - Remote

ARC Group

Jacksonville, FL • Remote

Full-time

Re-posted 15 days ago

Job description

CLINICAL REVIEW NURSE - REMOTE
ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected organization offering tremendous career growth potential.
At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply.
100% REMOTE!
Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering).
SUMMARY STATEMENT
The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care. The incumbent applies clinical knowledge to assess the medical necessity, level of services and appropriateness of care which may include cases requiring prior authorization, complex pre-payment medical review or post-payment medical review.
ESSENTIAL DUTIES & RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
90% of time will be spent on one or more of the following activities depending on assignments:
Review and analyze pre and post pay complex health care claims from a medical perspective, inclusive of prior authorization:
  • Perform clinical review work as assigned; may provide guidance to other team members and accurately interpret and apply broad CMS guidelines to specific and highly variable situations.
  • Conduct review of claim data and medical records to make clinical decisions on the coverage, medical necessity, utilization and appropriateness of care per national and local policies, as well as accepted medical standards of care.
  • Review provider practices and identify issues of concern, overpayment and need for corrective action as necessary; includes surfacing potential fraud and abuse or practice concerns.
  • May develop recommendations for further corrective action based on medical review findings.
  • May refer for review, or implement, corrective action related to medical review activities.
  • May process claims and complete project work in the appropriate computer system(s).

The remaining 10% of time will be spent on the following activities depending on assignments:
Identify providers needing education and individually educate providers who are subject to medical
review processes:
  • Initiate or participate in provider teaching activities, creating written teaching material, providing one on one education or education to a group as a result of a medical review (e.g., probe, progressive corrective action, consent, etc.) or appeal.
  • This may involve discussion with CMS leaders and leaders in the provider community.
  • Participate in special projects as assigned.

REQUIRED QUALIFICATIONS
* Valid nursing degree
* 2 years' clinical experience
* Excellent written and oral communication skills
* Demonstrated experience with evaluating medical and health care delivery issues (e.g., Inpatient Rehab Facility)
* Strong computer skills to include Microsoft Office proficiency
* Valid unrestricted Registered Nurse (RN) license
PREFERRED QUALIFICATIONS
* Inpatient Rehabilitation Facility Experience
* Bachelor of Science in Nursing (BSN)
* Insurance industry experience
* Certified Coder
ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed.
At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know.
Position is offered with no fee to candidate.