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One Call Clinical Reviewer Jobs (NOW HIRING)

IPRO

Clinical Reviewer RN (Proofer)

Jericho, NY

$36.06 - $43.27/hr

Clinical Reviewer RN (Proofer) In the Clinical Reviewer RN (Proofer) role, you will review all NYS ... AND /OR one to three year's experience in acute care utilization review, required. The salary range ...

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One Call Clinical Reviewer information

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How much do one call clinical reviewer jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for one call clinical 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 One Call Clinical Reviewer?

A One Call Clinical Reviewer is a healthcare professional, often a nurse or physician, who evaluates medical records and treatment requests to determine if they meet established clinical guidelines and policies. Their primary role is to ensure that patients receive appropriate, evidence-based care while helping manage costs and utilization for insurance or workers’ compensation cases. They work within the One Call organization, which specializes in healthcare solutions, particularly for workers’ compensation and related services. Clinical reviewers must possess strong analytical skills and a thorough understanding of medical standards and regulations.

What is the difference between One Call Clinical Reviewer vs Medical Case Reviewer?

AspectOne Call Clinical ReviewerMedical Case Reviewer
CredentialsRN or licensed healthcare professionalRN or licensed healthcare professional
Work EnvironmentRemote, healthcare insurance, or third-party review companiesRemote, insurance companies, or healthcare organizations
Employer & IndustryThird-party review firms, insurance carriersInsurance companies, healthcare organizations

Both roles require healthcare credentials and involve reviewing medical cases remotely. The main difference lies in the specific job focus: One Call Clinical Reviewers often handle urgent or immediate case assessments, while Medical Case Reviewers may focus on comprehensive case evaluations for insurance claims or treatment plans.

What are some common challenges faced by One Call Clinical Reviewers, and how can applicants prepare for them?

One Call Clinical Reviewers often face the challenge of managing a high volume of case reviews while ensuring accuracy and compliance with clinical guidelines. Balancing efficiency with attention to detail is essential, as reviewers are responsible for making evidence-based decisions that impact patient care and insurance approvals. To prepare, applicants should familiarize themselves with current clinical protocols and develop strong organizational and communication skills, as collaboration with physicians, case managers, and insurance representatives is frequent.

What are the key skills and qualifications needed to thrive as a One Call Clinical Reviewer, and why are they important?

To excel as a One Call Clinical Reviewer, you need a solid background in healthcare, clinical assessment skills, and typically a current RN, PT, or OT license. Familiarity with utilization review software, electronic medical records (EMRs), and knowledge of regulatory guidelines such as Medicare and Medicaid is important. Strong analytical thinking, attention to detail, and effective written and verbal communication skills help you stand out in this role. These abilities ensure accurate, timely clinical reviews and facilitate appropriate care decisions in a regulatory-compliant manner.
Infographic showing various One Call Clinical Reviewer job openings in the United States as of May 2026, with employment types broken down into 88% Full Time, 9% Part Time, and 3% Contract. Highlights an 85% In-person, and 15% Remote job distribution, with an average salary of $74,707 per year, or $35.9 per hour.

Clinical Reviewer (RN)

ISLAND PEER REVIEW ORGANIZATION INC

Jericho, NY • On-site

$38.46 - $43.27/hr

Full-time

Posted 25 days ago

Job description

As the Clinical Reviewer, you will be responsible for the review and processing of all requests for Independent Reviews from External Agencies in accordance with contractual guidelines. Upon receipt of the electronic medical records, communicate with contractors, providers and beneficiary/representatives. Duties include but are not limited to: Performing case reviews utilizing regulatory guidelines criteria and clinical knowledge for medical necessity and quality of care issues; formulate a case summary and the review questions for the Physician Reviewer based upon the External Agency’s concern(s), reviewing physician determinations, ensuring all categories of concern have been addressed and preparing written correspondences to contractors, providers and beneficiaries/representatives.

This is a full-time position based in the Jericho, NY office. Ability to work remotely one day per week after introduction period.

QUALIFICATIONS:

  • The ability to interact with providers, internal/external customers and representatives.
  • Excellent communication skills (both verbal and writing) with a professional demeanor
  • The ability to work independently, as well as in a team environment.
  • Excellent time management/ prioritization skills to meet contractual deadlines while maintaining a high level of quality work to meet customer satisfaction and standards.
  • Strong clinical critical thinking skills
  • Advanced skills and knowledge of standard EHR applications, office technology and
  • Microsoft applications including Word, Excel, and PowerPoint.
  • Ability to handle sensitive and confidential information.

EDUCATION & EXPERINCE:

  • Licensed Registered Nurse, required (open to any RN state license).
  • Graduate of a School of Nursing, required.
  • Bachelor of Science in Nursing (BSN), required
  • A minimum of three (3) years clinical experience in an acute care setting or related experience, required.
  • Experience in utilization and quality reviews, required.
  • Experience in managed care, quality management and peer review, preferred.

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The hourly range for this position is $38.46 – $43.27. Actual salary range and /or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.


The salary range and/or hourly rate listed does not include other forms of compensation or benefits.

IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.