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Remote Case Reviewer Jobs in Missouri (NOW HIRING)

Beacon Talent

Remote Psychiatrist

Saint Louis, MO · Remote

$150 - $200/hr

Document within our behavioral health EMR to the standard required for payer review * Escalate ... Full admissions and assessment support on every case * Average of [XX] encounters per shift, with ...

MDS Solutions

REMOTE MDS Coordinator

Kansas City, MO · Remote

$33.50 - $42.75/hr

Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Kansas City, MO · On-site +1

$33.50 - $42.75/hr

Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Kansas City, MO · On-site +1

$33.50 - $42.75/hr

Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ... Review and verify MDS documentation and charting requirements to support the clinical services ...

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All JobsCase Reviewer JobsRemote Case Reviewer JobsRemote Case Reviewer Jobs in Missouri

Remote Case Reviewer information

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 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 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 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 the most commonly searched types of Case Reviewer jobs in Missouri?

The most popular types of Case Reviewer jobs in Missouri are:

What are popular job titles related to Remote Case Reviewer jobs in Missouri?

For Remote Case Reviewer jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Remote Case Reviewer jobs in Missouri look for?

The top searched job categories for Remote Case Reviewer jobs in Missouri are:

What cities in Missouri are hiring for Remote Case Reviewer jobs?

Cities in Missouri with the most Remote Case Reviewer job openings:

Remote Case Reviewer jobs near you
Infographic showing various Remote Case Reviewer job openings in Missouri as of August 2026, with employment types broken down into 72% Full Time, 14% Part Time, and 14% Contract. Highlights an 100% Remote job distribution.

Senior Nurse Case Manager

memployersmins

Kansas City, MO • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

Do you believe great outcomes happen when compassionate care, proactive communication, and workplace recovery come together? At MEM Insurance, we're looking for a dedicated Nurse Case Manager to help injured workers navigate their recovery journey while supporting safe and timely return-to-work outcomes.
 
In this role, you will serve as a trusted partner between injured workers, healthcare providers, employers, and claims professionals. You will coordinate medical treatment plans, monitor recovery progress, identify barriers to successful rehabilitation, and advocate for appropriate care within the workers' compensation system. Through regular communication and relationship building, you will help ensure injured workers receive quality, cost-effective healthcare while promoting the best possible recovery outcomes.
 
This position is primarily an on-site regional role with regular interaction with injured workers, medical providers, employers, and internal stakeholders.
 
Why Join MEM Insurance?
At MEM Insurance, our mission goes beyond workers' compensation insurance. We are committed to helping employers create safer workplaces and helping injured workers recover safely and successfully. We believe our employees are our greatest asset, and we strive to create an environment where people feel valued, supported, and empowered to make a meaningful difference every day.
 
As a Nurse Case Manager, you'll have the opportunity to build strong relationships, positively impact lives, and work alongside a team that values collaboration, service, accountability, and continuous improvement. You'll be trusted to use your clinical expertise while receiving the support and resources needed to grow your career.
 
Essential Duties and Responsibilities
  • Coordinate and manage medical treatment plans for injured workers throughout the life of the claim.
  • Serve as a liaison among injured workers, healthcare providers, employers, therapists, and claims professionals to ensure effective communication and care coordination.
  • Assess medical information and treatment progress to identify opportunities that support recovery and safe return-to-work outcomes.
  • Evaluate return-to-work potential by considering medical status, job demands, vocational history, educational background, and other relevant factors.
  • Develop individualized case management strategies that promote quality care and positive rehabilitation outcomes.
  • Advocate for appropriate medical treatment and identify gaps or barriers that may impact recovery within the workers' compensation system.
  • Gather and maintain critical case information, including job descriptions, medical history details, treatment documentation, and related records.
  • Conduct ongoing telephonic and remote case management activities, including follow-up calls, provider communication, email correspondence, and documentation.
  • Maintain accurate, timely, and confidential case records and documentation within company systems.
  • Review medical files and treatment plans to provide recommendations and support quality care decisions.
  • Ensure compliance with applicable regulations, company policies, confidentiality requirements, and documentation standards.
  • Monitor case progress and communicate updates regularly with leadership, claims professionals, employers, and medical providers.
  • Maintain an active caseload and prioritize activities to effectively manage competing responsibilities and deliver exceptional service.
  • Participate in ongoing professional development to maintain current knowledge of healthcare trends, workers' compensation practices, regulations, and industry best practices.
 QualificationsEducation
  • Associate Degree in Nursing or completion of a Diploma Registered Nurse Program required.
Licenses & Certifications
  • Active Registered Nurse (RN) designation required.
  • Certification in Case Management through the Case Management Society of America (CMSA) preferred.
Experience
  • 3+ years of clinical nursing experience in Medical/Surgical settings required.
  • 5+ years of insurance or workers' compensation case management experience preferred.
     
    Company Culture and Values
    At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.
     
     Connection and Belonging
    MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.
     
     Total Rewards Overview

    Health Plans: Medical, Dental, and Vision
    Includes fertility benefits, fully paid preventative care, and adult orthodontia.

    Employer-Paid Life and Disability Benefits:
    Life Insurance (3x base salary), AD&D, Short and Long-term Disability.

    Wellness and Recognition Program: Employer-paid incentives for employees and spouses.

    Flexible Spending Account and Dependent Care options

    Health Savings Account: Generous employer contribution.

    Time Away from Work:
    Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.

    Employee Assistance Programs

    401k Retirement Plan: Employer match and profit sharing.

    Adoption Assistance and Tuition Assistance

     
    Notice Regarding Use of Artificial Intelligence
    MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

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