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Insurance Review Nurse Jobs (NOW HIRING)

CorVel

CA Utilization Review Nurse I

$30.64 - $45.80/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Nurse The Utilization Review Nurse gathers demographic and clinical information ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

CERIS Health

Itemization Review Nurse I

$52K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Itemization Review Nurse The Itemization Review Nurse provides a summary and analysis of items by ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Actalent

Clinical Review Nurse - Remote

$34 - $40/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Clinical Review Nurse (Remote) We are seeking a detail-oriented and clinically skilled Clinical ... Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term ...

New

CERIS Health

Itemization Review Nurse II

$61K - $98K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Itemization Review Nurse The Itemization Review Nurse provides a summary and analysis of items by ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

Corvel

Itemization Review Nurse I

Fort Worth, TX · On-site

$52K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

CorVel

Itemization Review Nurse I

Fort Worth, TX · On-site

$52K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

CERiS

Itemization Review Nurse I

Fort Worth, TX · On-site

$52K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

CERIS Health

Itemization Review Nurse I

Fort Worth, TX · On-site

$52K - $85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

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Showing results 41-60

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Insurance Review Nurse information

See salary details

$23.5K

$59.1K

$97.5K

How much do insurance review nurse jobs pay per year?

As of Aug 19, 2026, the average yearly pay for insurance review nurse in the United States is $59,095.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,500.00 and $77,500.00 per year, depending on experience, location, and employer.

What is an insurance review nurse?

Insurance Review Nurses are registered nurses who evaluate medical records and treatment plans to determine if healthcare services are medically necessary and covered by insurance policies. They act as a liaison between healthcare providers, patients, and insurance companies to ensure that claims meet policy guidelines. Their work helps prevent unnecessary treatments and controls healthcare costs while ensuring patients receive appropriate care.

What skills and qualifications are needed to be an insurance review nurse?

To thrive as an Insurance Review Nurse, you need a registered nursing license, strong clinical knowledge, and experience in case management or utilization review. Familiarity with medical coding systems (such as ICD-10 and CPT), healthcare regulations, and insurance software platforms is typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating medical records and collaborating with providers. These skills ensure accurate, efficient reviews that support appropriate coverage decisions and compliance with regulatory standards.

What challenges do insurance review nurses face when evaluating medical necessity for insurance claims?

Insurance Review Nurses often encounter challenges such as interpreting complex medical records, staying current with evolving insurance policies and clinical guidelines, and balancing the interests of patients, providers, and insurers. They must exercise critical thinking to make impartial decisions while navigating tight deadlines and high caseloads. Collaborating effectively with physicians, case managers, and claims adjusters is crucial to ensure accurate and fair assessments.

What is the difference between Insurance Review Nurse vs Claims Nurse?

AspectInsurance Review NurseClaims Nurse
CredentialsRN license, possibly certifications in case management or insuranceRN license, certifications in case management or insurance
Work EnvironmentReviewing insurance claims, assessing coverage, working with insurance companiesHandling patient claims, coordinating with insurance providers, clinical assessments
Employer & IndustryInsurance companies, third-party administratorsHospitals, insurance companies, healthcare providers

Both roles require RN licensure and similar certifications, often working within insurance or healthcare settings. Insurance Review Nurses primarily evaluate insurance claims for coverage and compliance, while Claims Nurses handle patient claims, ensuring proper processing and coordination. Although their tasks differ, both roles focus on insurance and healthcare integration, making them closely related in the industry.

More about Insurance Review Nurse jobs

What cities are hiring for Insurance Review Nurse jobs?

Cities with the most Insurance Review Nurse job openings:

What states have the most Insurance Review Nurse jobs?

States with the most job openings for Insurance Review Nurse jobs include:

What job categories do people searching Insurance Review Nurse jobs look for?

The top searched job categories for Insurance Review Nurse jobs are:

Insurance Review Nurse jobs near you
Infographic showing various Insurance Review Nurse 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 $59,095 per year, or $28.4 per hour.

CA Utilization Review Nurse I

CorVel

Remote

$30.64 - $45.80/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 27 days ago

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

85th of 150 rated financial services

Job description

Utilization Review Nurse

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position.

Essential Functions & Responsibilities:

  • Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
  • Collects data and analyzes information to make decisions regarding certification or denial of treatment
  • Documents all work in the appropriate manner
  • Promotes utilization review services with stakeholders
  • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as assigned

Knowledge & Skills:

  • Must have thorough knowledge of both CPT and ICD coding
  • Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
  • Effective organization skills in a high-volume, fast-paced environment
  • Strong time management skills with the ability to meet designated deadlines
  • Excellent written and verbal communication skills
  • Ability to work both independently and within a team environment
  • Strong interpersonal skills
  • Ability to utilize Microsoft Office including Excel spreadsheets
  • Knowledge of the workers' compensation claims process preferred
  • Knowledge of outpatient utilization review preferred

Education & Experience:

  • Graduate of accredited school of nursing with an associate's degree, Bachelor of Science degree or Bachelor of Science in Nursing
  • Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
  • 4 or more years of recent clinical experience
  • Prospective, concurrent, and retrospective utilization review experience preferred
  • Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

Pay Range: $30.64 - $45.80 per hour

About CorVel:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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