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Remote Case Reviewer Jobs in Arizona (NOW HIRING)

RemX

Remote Healthcare Case Manager $19/hr

Phoenix, AZ · On-site +1

$19/hr

Medical Case Manager Pay: $19/hr. Weekly Pay plus Benefits Schedule: Mon-Fri between 7am-8pm CST ... Please apply online and we will review your resume and contact you. If we have not contacted you ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will perform frequent case reviews, check medical records and speak with care providers ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Banner Health

RN, Case Manager

Phoenix, AZ · Remote

After completing training, it is a remote position with a work schedule of Monday - Friday 8am ... MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally ...

Bannerhealth

RN, Case Manager

Tucson, AZ · Remote

After completing training, it is a remote position with a work schedule of Monday - Friday 8am ... MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally ...

Arizona Department of Administration

$28.02/hr

... informal case reviews. Reviews and approves client cases. Knowledge, Skills & Abilities (KSAs ... Remote work is a management option and not an employee entitlement or right. An agency may ...

SimonMed Imaging

Remote Radiologist- Nuero

Scottsdale, AZ · Remote

$319K - $399K/yr

Participate in quality assurance, peer review, and continuous improvement initiatives. Maintain up ... Attend department meetings and contribute to case discussions and clinical education when ...

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Remote Case Reviewer information

What jobs pay 4000 a week without a degree?

A remote case reviewer typically earns around $4,000 per week with experience and strong attention to detail, often requiring knowledge of healthcare policies and review procedures. High-paying freelance or contract roles in fields like consulting, sales, or digital marketing can also reach this level without a degree, especially with specialized skills and a solid portfolio.

What are the key skills and qualifications needed to thrive as a Remote Case Reviewer, and why are they important?

To thrive as a Remote Case Reviewer, you need strong analytical skills, attention to detail, and relevant professional credentials, often in fields like healthcare, insurance, or law. Familiarity with case management software, electronic documentation systems, and industry regulations (such as HIPAA for healthcare) is typically required. Excellent written communication, time management, and independent decision-making are standout soft skills for this role. These abilities ensure accurate, compliant, and efficient case evaluations while maintaining high-quality standards in a remote work environment.

What is the difference between Remote Case Reviewer vs Remote Claims Processor?

AspectRemote Case ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; healthcare or legal background often preferredHigh school diploma or equivalent; experience in insurance or claims processing beneficial
Work EnvironmentHome-based, independent review settingHome-based, processing insurance claims
Industry UsageHealthcare, legal, insurance sectorsInsurance companies, third-party administrators
Common Search/ComparisonRemote Case Reviewer vs Remote Claims Processor

While both roles are remote and involve handling cases or claims, Remote Case Reviewers primarily evaluate and assess cases, often requiring specialized knowledge in healthcare or legal fields. Remote Claims Processors focus on processing insurance claims, verifying information, and ensuring accurate payment. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.

What are some common challenges Remote Case Reviewers face, and how can they effectively manage them?

Remote Case Reviewers often encounter challenges such as managing a high volume of cases, staying organized with digital documentation, and maintaining clear communication with team members across different locations. To address these, it's important to develop strong time management skills, utilize standardized review checklists, and take advantage of collaboration tools like secure messaging platforms. Regular virtual meetings and clear protocols help ensure consistency and quality, while ongoing training can keep reviewers up to date on best practices.

How can I make 2000 a week working from home?

A remote case reviewer can potentially earn $2,000 a week by handling a high volume of cases, maintaining accuracy, and working full-time hours. Increasing productivity, gaining relevant certifications, and using efficient case management tools can help maximize earnings within this role.

What are remote case reviewers?

Remote case reviewers are professionals who assess and evaluate cases, such as medical, legal, or insurance files, from a remote location rather than working on-site. Their responsibilities typically include reviewing documentation, ensuring compliance with policies and regulations, and providing recommendations or decisions based on their findings. Remote case reviewers use secure digital platforms to access and analyze case materials, enabling flexibility and efficiency in their work. This role can be found in industries like healthcare, law, insurance, and finance. Strong attention to detail and analytical skills are essential for success in this position.

What is a case reviewer?

A case reviewer is a professional responsible for evaluating and processing cases, such as insurance claims, legal matters, or healthcare records. They analyze documentation, ensure compliance with policies, and make determinations based on established guidelines, often using specialized software and requiring attention to detail.

Will Amazon really pay you to work-from-home?

Remote Case Reviewers are typically employed by companies like Amazon to evaluate customer cases from home. These roles usually offer a fixed salary or hourly pay, and the company provides necessary tools and training. Amazon and similar companies often have remote work programs that pay employees for their work-from-home tasks.
What are the most commonly searched types of Case Reviewer jobs in Arizona? The most popular types of Case Reviewer jobs in Arizona are:
What are popular job titles related to Remote Case Reviewer jobs in Arizona? For Remote Case Reviewer jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Remote Case Reviewer jobs in Arizona look for? The top searched job categories for Remote Case Reviewer jobs in Arizona are:
What cities in Arizona are hiring for Remote Case Reviewer jobs? Cities in Arizona with the most Remote Case Reviewer job openings:
Remote Case Reviewer jobs near you
Infographic showing various Remote Case Reviewer job openings in Arizona as of July 2026, with employment types broken down into 88% Full Time, and 12% Part Time. Highlights an 100% Remote job distribution.

Utilization Management Clinical Reviewer (Remote)

Tango Care

Phoenix, AZ • On-site, Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Description
tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and services designed to manage the total cost of care.
We are currently looking for Clinical Reviewers to join our growing Utilization Management team.
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review activities to ensure the appropriate, efficient, and cost-effective use of home health services. This role evaluates medical necessity for skilled nursing and therapy services (physical therapy, occupational therapy, and speech-language pathology) in accordance with company policies, CMS guidelines (including Medicare Chapter 7), and established clinical criteria such as Milliman Care Guidelines.
The UM Clinical Reviewer collaborates with providers, internal teams, and payer partners to promote high-quality patient outcomes, ensure regulatory compliance, and support optimal care planning across disciplines.
Key Responsibilities:
  • Review and process prior authorization, reauthorization, and continued stay requests for home health services (nursing and therapy)
  • Evaluate medical records and clinical documentation to determine medical necessity and appropriateness of care
  • Apply CMS guidelines, NCQA standards, and internal clinical policies when making authorization determinations
  • Refer complex or non-compliant cases to Physician Advisors or Medical Directors as appropriate
  • Collaborate with providers to support appropriate utilization of skilled nursing and therapy visits
  • Serve as a clinical resource to internal team members and external partners, including providers, payers, and case managers
  • Facilitate effective communication to ensure alignment on care plans, documentation standards, and authorization decisions
  • Monitor adherence to home health regulations, documentation standards, and medical necessity criteria
  • Maintain accurate and timely documentation of reviews, decisions, and communications
  • Identify trends or issues impacting quality or utilization and escalate to leadership or quality committees as needed 7
  • Participate in interdisciplinary collaboration and support continuous improvement initiatives
  • Meet productivity, turnaround time, and quality standards for review completion 8
  • Participate in periodic weekend/holiday coverage based on business needs 9 10
  • Perform additional duties as assigned

Office Location:
  • Office located at 2415 E Camelback Road, Suite 700, Phoenix, AZ 85016
  • Remote

Qualifications:
Education & Licensure (one of the following required):
  • Graduate of an accredited nursing program (RN, LPN, or LVN), or
  • Graduate of an accredited Physical Therapy (PT), Occupational Therapy (OT), or Speech-Language Pathology (SLP) program
  • Active, unrestricted clinical license in good standing (multi-state licensure preferred where applicable)

Experience:
  • Minimum 2-5 years of clinical experience (home health, medical/surgical, or therapy setting)
  • Experience in utilization review, case management, or managed care strongly preferred
  • Home health experience strongly preferred

Knowledge and Experience:
  • Strong understanding of home health regulations, CMS guidelines, and medical necessity criteria
  • Knowledge of utilization management principles and care coordination practices
  • Familiarity with NCQA and URAC standards preferred
  • Ability to analyze clinical documentation and make independent, evidence-based decisions
  • Excellent written and verbal communication skills
  • Strong organizational skills with the ability to manage multiple priorities and meet deadlines
  • Ability to work independently while collaborating effectively across teams
  • Customer-service oriented mindset when working with providers and partners
  • Proficiency in Microsoft Office and electronic medical management systems

Additional Expectations
Employees are expected to:
  • Participate in ongoing education and training
  • Stay current on regulatory updates and clinical guidelines
  • Contribute to a culture of quality, compliance, and continuous improvement

tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.

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