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Remote Case Reviewer Jobs in Florida (NOW HIRING)

MedWatch, LLC

Case Manager / RN

Lake Mary, FL · On-site +1

$72K - $81K/yr

This is a remote/work-from-home position. License Requirements : * Registered Nurse (current active ... Review all medical data which can be provided to establish, update and maintain accountability for ...

Oscar Health

Utilization Review Nurse

Miami, FL · 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;

MedWatch, LLC

Case Manager Assistant / LPN

Lake Mary, FL · On-site +1

$23 - $27/hr

This is a Remote (work from home) position. License Requirements: * Licensed Practical Nurse or ... Review all medical data which can be provided to update a case management plan which will ...

micro1 AI

Computational Biologist - AI Reviewer

Hialeah, FL · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

micro1 AI

Computational Biologist - AI Reviewer

Tampa, FL · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

micro1 AI

Computational Biologist - AI Reviewer

Miramar, FL · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

micro1 AI

Computational Biologist - AI Reviewer

Orlando, FL · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

micro1 AI

Computational Biologist - AI Reviewer

Davie, FL · On-site +1

$90 - $120/hr

Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...

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All JobsCase Reviewer JobsRemote Case Reviewer JobsRemote Case Reviewer Jobs in Florida

Remote Case Reviewer information

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

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.

What is a remote case reviewer?

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 are the most commonly searched types of Case Reviewer jobs in Florida? The most popular types of Case Reviewer jobs in Florida are:
What are popular job titles related to Remote Case Reviewer jobs in Florida? For Remote Case Reviewer jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Case Reviewer jobs in Florida look for? The top searched job categories for Remote Case Reviewer jobs in Florida are:
What cities in Florida are hiring for Remote Case Reviewer jobs? Cities in Florida with the most Remote Case Reviewer job openings:
Remote Case Reviewer jobs near you
Infographic showing various Remote Case Reviewer job openings in Florida as of August 2026, with employment types broken down into 73% Full Time, 15% Part Time, and 12% Contract. Highlights an 100% Remote job distribution.

Case Manager / RN

MedWatch, LLC

Lake Mary, FL • On-site, Remote

$72K - $81K/yr

Full-time

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

Job description

Scope:
The Case Manager manages an individual caseload using the case management process in order to meet the needs of the MedWatch, LLC customers and consumers. This includes, but is not limited to, authorization of services, review of treatment plans for medical necessity, standards of care, and ongoing communication with all members of the health care team. This is a remote/work-from-home position.
License Requirements:
  • Registered Nurse (current active and unrestricted, in state of current practice and residence, within the United States or its territories.)
Education:
  • R.N., a bachelor's degree in a health-related field preferred.
Experience:
  • 7 years of varied clinical experience preferred.
Responsibilities:
  • The Registered Nurse Case Manager will practice within the scope of his/her licensure.
  • Review all medical data which can be provided to establish, update and maintain accountability for a case management plan which will incorporate contact with providers, payers, with the patient and with the patient's primary caregiver.
  • Assess problems and determine goals and actions designed to meet the needs of the patient and document into the case notes. Determine if these goals are long term or short term and how the patient can be expected to meet those goals. Include the action/intervention the case manager will take to work towards achieving those goals.
  • Make contact with the payer office to find out and understand any benefit constraints that will have an impact on the plan of action.
  • Proceed with contacting medical care providers and with equipment vendors to verify medical necessity of care or equipment that has been ordered.
  • Make care arrangements for quality patient care according to the needs of the patient, the physician's orders and the benefits available.
  • The Case Manager will work in conjunction with the Case Management Assistant to manage case management files, exclusive of Assessment and/or Care Plan activities, and will provide input in the Annual Performance Evaluation of the CM Assistant assigned. The Case Manager will maintain responsibility for the Case Management file.
  • Be aware of any alternative treatment possibilities that may allow the patient to reach wellness goal(s). If there are no benefits available for your recommended alternative treatments, provide to the payer a cost-benefit analysis to demonstrate that extra-contractual services will enhance the patient's medical condition and will be cost-effective to the benefit plan.
  • Become familiar with community resources and funding sources so that the patient can receive quality health care and conserve health benefit dollars. Many agencies exist which provide assistance to persons in financial need or to provide information to persons with specific medical conditions.
  • Maintain case in computer system documenting case actions for each patient under your case management. Complete all aspects of case in the computer. Prepare timely reports to the payer to detail all case actions, the results of those actions, and the continuing case management plan.
  • Maintain billing as appropriate in computer system.
  • Continue to maintain contact with the providers and with the patient across the continuum of care to be sure that patient needs are being met. On any cases which include a chronic condition keep the file open for periodic contacts to verify the clinical status of the patient and additional medical needs.
  • Negotiate with providers to maximize the medical benefits available to the patient. Make network referral as appropriate.
  • Act upon any awareness of non-medical issues which involve the patient's safety or welfare. Attempt to direct the patient or family to appropriate providers or community resources, or to personally notify appropriate authorities. Consult with the CM supervisor on a regular basis, and keep the supervisor informed regarding any complaints which may occur about case management services or any issues which arise which the case manager is not competent to handle or does not have the expertise to handle.
  • Adhere to all company policies as stated in the employee handbook.
  • All case managers will possess a URAC-recognized certification in Case Management within 3 years of hire. Participate in the Quality Management Program by adhering to all company policies and procedures and identifying opportunities for improvement to ensure quality services are rendered to clients and customers.
  • This position is eligible for a bonus program.
The salary range for this position is from $72,000 to $81,000 annually.
Work Environment / Physical Demands: This position is in a typical home office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment.
We are an Equal Opportunity Employer, including disability/veterans.

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