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Overnight Insurance Nurse Reviewer Jobs (NOW HIRING)

Zimmerman Associates, Inc.

$24.13/hr

Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty ... Processing/Insurance Referral * U.S. Citizenship required, with the ability to obtain a Public ...

Zimmerman Associates, Inc.

$23.56/hr

Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty ... Processing/Insurance Referral * U.S. Citizenship required, with the ability to obtain a Public ...

Cohere Health

Lead RN Reviewer

$35 - $37/hr

Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare ... Other duties as assigned What you'll need: * 5+ years in healthcare, managed care, or insurance ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

$75K - $95K/yr

The Utilization Management Authorization Review Nurse is responsible for managing inpatient ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

The Utilization Management Authorization Review Nurse is responsible for managing inpatient ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Dane Street

PRN Utilization Review Nurse Reviewer

Utilization Management Nurse Reviewers collaborate with healthcare providers, insurance companies, and patients to optimize healthcare delivery, control costs, and maintain quality care. Their ...

Astiva Health, Inc

UM Nurse Reviewer

Orange, CA · On-site

Utilization Management Authorization Review Nurse Astiva Health, Inc., located in Orange, CA is a ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

$75K - $95K/yr

The Utilization Management Authorization Review Nurse is responsible for managing inpatient ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Care Navigators On Demand

We currently have an opening for Clinical Nurse Reviewer The Clinical nurse reviewer will ... We offer a generous PTO package, 401k Retirement Savings, Life Insurance, Flexible Spending Account ...

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All JobsInsurance Nurse Reviewer JobsOvernight Insurance Nurse Reviewer Jobs

Overnight Insurance Nurse Reviewer information

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How much do overnight insurance nurse reviewer jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for overnight insurance nurse reviewer in the United States is $30.01, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $40.87 per hour, depending on experience, location, and employer.

What is the difference between Overnight Insurance Nurse Reviewer vs Insurance Claims Nurse?

AspectOvernight Insurance Nurse ReviewerInsurance Claims Nurse
CredentialsRN license, insurance review certificationsRN license, insurance claims processing certifications
Work EnvironmentRemote, reviewing insurance claims overnightOffice or remote, handling claims during regular hours
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, healthcare providers
Search & Comparison IntentRoles involving overnight review of insurance claimsRoles focused on processing insurance claims during business hours

The main difference is that Overnight Insurance Nurse Reviewers primarily work overnight reviewing insurance claims remotely, focusing on detailed assessments. Insurance Claims Nurses typically handle claims during regular hours, often involving more direct communication with clients and providers. Both roles require nursing credentials and insurance knowledge but differ mainly in work hours and specific job functions.

How to become an overnight insurance nurse reviewer?

To become an overnight insurance nurse reviewer, you typically need a valid registered nurse (RN) license and experience in clinical or insurance review settings. Strong assessment, documentation, and communication skills are essential, and familiarity with medical coding and insurance policies can be beneficial. Some positions may require certification in case management or utilization review.

What cities are hiring for Overnight Insurance Nurse Reviewer jobs?

Cities with the most Overnight Insurance Nurse Reviewer job openings:

What are the most commonly searched types of Insurance Nurse Reviewer jobs?

The most popular types of Insurance Nurse Reviewer jobs are:

What states have the most Overnight Insurance Nurse Reviewer jobs?

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

Overnight Insurance Nurse Reviewer jobs near you

Referral Management (Non-Nurse) Reviewer

Zimmerman Associates, Inc.

Bethesda, MD • On-site

$24.13/hr

Full-time

Re-posted 22 days ago

Job description

Zimmerman Associates, Inc. (ZAI) is seeking to hire multiple Referral Management (Non-Nurse) Reviewers to support our contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Region's premier authority for appointment coordination and referral management services for beneficiaries within the Defense Health Network.
Pay Rate: $24.13 per hour plus $5.09 Health & Wellness Fringe
Role and Responsibilities:
Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty referrals for Active-Duty Service Members and TRICARE Prime beneficiaries enrolled at Military Treatment Facilities (MTFs) within the National Capital Region.
This is an onsite opportunity
Qualifications / Skills / Experience:
  • Minimum of an Associate's degree
  • At least 2 years of experience in Utilization Management, Referral Management, Authorization/Denials, or Medical Claims Processing/Insurance Referral
  • U.S. Citizenship required, with the ability to obtain a Public Trust Clearance
  • Knowledge of medical care criteria such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs), or other evidence-based Military Health System (MHS) guidelines
  • Familiarity with medical terminology and ability to learn MHS, VA-DOD Sharing Program, TRICARE, HIPAA, and release of medical information protocols
  • Excellent communication and interpersonal skills
  • Strong customer service orientation
  • Understanding of Access to Care Standards within the Direct Care System
  • Attention to detail, including correct use of deferral codes
  • Strong organizational skills with ability to prioritize tasks and manage time effectively
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook) and internet navigation
Essential Tasks:
  • Review and process referrals for administrative and clinical completeness and appropriateness, completing disposition within 24 hours of referral date
  • Collaborate with appointing centers, case managers, product line nurses, providers, clinics, managed care contractors, and other healthcare team members to ensure appropriate use of Direct Care and civilian network resources
  • Ensure patients are scheduled with the right provider, at the right time and place
  • Review compliance with Specialty Referral Guidelines (SRGs) per IRMAC protocols
  • Complete and return Clear Legible Reports (CLR) to ordering civilian providers within required Return of Favorable Response (ROFR) timelines
  • Manage telephone, written, and electronic communications regarding specialty appointments and referrals
  • Monitor and process referral management worklists (e.g., Genesis Work Lists) to ensure timely consult processing
  • Communicate referral status to patients, including benefit counseling and advocacy resources as needed
  • Reschedule or redirect patients within 3 days when referrals are disapproved or invalid, advising on other care options and Line-of-Duty issues
  • Receive and enter ROFR referrals in MHS-GENESIS from Military Contractor Support Centers (MCSC) portals for assigned specialties/product lines, adhering to all timelines and business rules
  • Verify patient eligibility and update demographics in MHS-GENESIS
  • Document patient interactions, especially when appointments are refused, and coordinate with Beneficiary Counselor and Assistance Coordinator as appropriate
  • Coordinate with product line nurses and clinics for special accommodations
  • Interface with MCSC and multidisciplinary teams to ensure referral appropriateness
  • Submit referrals to non-network providers for TRICARE Service Center medical necessity reviews
  • Monitor referral management voicemail and return patient calls within established guidelines
  • Provide External Provider Referral Online (EPRO) information as requested
  • Close unused referrals following DHA IPM and NCR Medical Directorate policies, notifying ordering providers accordingly
  • Orient and train new IRMAC staff on referral processes and timelines
  • Perform other duties as assigned

Zimmerman Associates, Inc. is an equal opportunity employer. We comply with Federal and State Equal Opportunity laws and consider qualified applicants without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status, or any other protected status.
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