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Contract Remote Nurse Reviewer Jobs (NOW HIRING)

BreatheSuite Inc

Remote Nurse Practitioner

Denver, CO · Remote

Job Title:Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure ... review * Develop and manage individualized care plans for patients with chronic lung conditions

Comagine

Clinical Reviewer

This is a remote position based in Oregon and travel is required. Why Comagine Health? Comagine ... Current, active, unrestricted clinical licensure as required by the Oregon contract (e.g., RN or ...

STI

Healthcare Construction Plan Reviewer - REMOTE

Healthcare Construction Plan Reviewer REMOTE 9+ Months Description: The Healthcare Construction Plan Reviewer is responsible for evaluating electronic construction drawings and specifications for ...

Downs Law, LLC

Be Seen First

Experienced Contract/Remote Attorney for Civil Litigation Practice

Atlanta, GA · Remote

$100K - $200K/yr

We are seeking an experienced attorney to assist with our caseload on a contract/remote basis. The ... Responsibilities · Draft, review, and negotiate a diverse range of agreements · Prepare, finalize ...

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Contract Remote Nurse Reviewer information

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How much do contract remote nurse reviewer jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for contract remote nurse reviewer in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What is a contract remote nurse reviewer?

A Contract Remote Nurse Reviewer is a licensed nurse who works remotely, usually on a contract basis, to review medical records, claims, and healthcare documentation. Their main role is to assess the medical necessity, appropriateness, and quality of patient care, often for insurance companies, healthcare organizations, or legal purposes. They ensure that treatments and services provided meet established guidelines and help prevent fraud or unnecessary procedures. This position allows nurses to use their clinical expertise in a non-clinical, flexible work-from-home setting. Contract roles typically mean assignments may be temporary or project-based.

What are the key skills and qualifications needed to thrive as a contract remote nurse reviewer?

To thrive as a Contract Remote Nurse Reviewer, you need a valid RN license, solid clinical experience, and strong analytical skills in medical record review. Familiarity with utilization management software, electronic health records (EHR), and knowledge of regulatory guidelines like CMS or NCQA is essential. Excellent written communication, attention to detail, and the ability to work independently are standout soft skills for this role. These competencies are crucial for delivering accurate, timely reviews that support quality patient care and regulatory compliance in a remote setting.

What are some common challenges faced by contract remote nurse reviewers, and how can they be managed effectively?

Contract Remote Nurse Reviewers often encounter challenges such as adapting to varying client documentation systems, managing tight deadlines, and maintaining effective communication with healthcare teams while working remotely. To manage these effectively, it's helpful to become proficient in multiple electronic health record (EHR) platforms, establish a structured daily routine, and use collaboration tools like secure messaging or video conferencing. Staying organized and proactively reaching out to colleagues or supervisors for clarification can also ensure accuracy and efficiency in case reviews.

What is the difference between Contract Remote Nurse Reviewer vs Contract Remote Nurse Auditor?

AspectContract Remote Nurse ReviewerContract Remote Nurse Auditor
CertificationsRN license, clinical experienceRN license, clinical experience, auditing certifications (if any)
Work EnvironmentRemote, reviewing medical records and claimsRemote, auditing healthcare claims and documentation
Employer & Industry UsageHealthcare providers, insurance companiesInsurance companies, third-party administrators

Both roles require RN licensure and clinical experience, with the main difference being that Contract Remote Nurse Reviewers focus on evaluating medical records for appropriateness, while Contract Remote Nurse Auditors analyze claims and billing for accuracy. They often work in similar remote healthcare environments and are used by insurance companies and healthcare organizations. The roles are closely related but differ in their specific focus within healthcare compliance and review processes.

How to become a contract remote nurse reviewer?

To become a contract remote nurse reviewer, candidates typically need a valid nursing license, relevant clinical experience, and strong knowledge of medical documentation and coding. Many roles require familiarity with electronic health records (EHR) systems and attention to detail. Certification in case management or medical review is often preferred but not always mandatory.
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Contract Remote Nurse Reviewer jobs near you
Infographic showing various Contract Remote Nurse Reviewer job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Medical Claim Reviewer (CGS, DMEC-B)

Broadway Ventures

OR • On-site, Remote

Full-time

Re-posted 26 days ago

Job description

Max Salary: W-2 ($65,000/$31.25)

Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience.
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.

Apply