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Remote Case Reviewer Jobs (NOW HIRING)

CACI International, Inc.

DHS Experienced Case Reviewer

$20.50 - $26.25/hr

DHS Experienced Case Reviewer Job Category: Investigation Time Type: Full time Minimum Clearance ... fully remote position, however, there may be local travel to attend business meetings.

TEEMA

RN Clinical Quality Reviewer

Phoenix, AZ · Remote

$40 - $43/hr

Job Summary RN Clinical Quality Reviewer TEEMA Full-time Remote | Phoenix, AZ, United States ... Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations

OncoHealth

Case Review Specialist

About the Role The Case Review Specialist ensures that case documentation is provided by the ... Experience working remote independently * A minimum of 2-4 years' administrative experience and/or ...

State of Colorado

Administrative Reviewer

Denver, CO · On-site +1

$6.0K - $9.6K/mo

The federally required child welfare Case Review and Qualitative Case Review systems ... This position follows a hybrid work arrangement, combining remote work with regular travel. The ...

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Remote Case Reviewer information

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$19

$47

$80

How much do remote case reviewer jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for remote case reviewer in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.

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.

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.
More about Remote Case Reviewer jobs
What cities are hiring for Remote Case Reviewer jobs? Cities with the most Remote Case Reviewer job openings:
What are the most commonly searched types of Case Reviewer jobs? The most popular types of Case Reviewer jobs are:
What states have the most Remote Case Reviewer jobs? States with the most job openings for Remote Case Reviewer jobs include:
What job categories do people searching Remote Case Reviewer jobs look for? The top searched job categories for Remote Case Reviewer jobs are:
Remote Case Reviewer jobs near you
Infographic showing various Remote Case Reviewer job openings in the United States as of June 2026, with employment types broken down into 79% Full Time, 7% Part Time, and 14% Temporary. Highlights an 100% Remote job distribution, with an average salary of $98,869 per year, or $47.5 per hour.

Remote Case Manager, Clinical Review & Care Optimization

Allied

Chicago, IL • On-site, Remote

$50K - $55K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 17 days ago

Job description

POSITION SUMMARY:
The Case Manager I position will have a full understanding of the Enhanced Case Management (ECM) suite of strategies and supports the Enhanced Care Advocate and ECM team. The Specialist will primarily focus on vendor, carrier, and Center for Medicare and Medicaid Services (CMS), and member communication for purposes of case evaluation, appropriate referral making and determining impacts.
ESSENTIAL FUNCTIONS:
  • Review clinicals, claims and baseline case information for health scenarios such as Behavioral, Wellness, and Specialty Prescription, Maternity etc.
  • Develop strategic, initiative care plans to support members with varying health scenarios by connecting them to specialized vendor partners and Allied Care Clinicians that can facilitate the needs of the member.
  • Implement the care plan by coordinating with the member, client, Allied staff and/or the various specialized vendor partners.
  • Work closely with the Clinical Case Management team and other Case Managers to obtain clinical information needed to support the care plan. This includes case presentation when needed to discuss collaboratively to identify and troubleshoot escalated issues within case work.
  • Communicate with (CMS) to obtain essential member information.
  • Facilitate and maintain prescription drug vendor relationships, negotiate pricing as needed, manage member set-up, and provide on-going support.
  • Document the impact of the casework to highlight cost savings and the improvement of member health outcomes as a result of implanting a plan of care.
  • Perform assorted weekly and monthly administrative tasks.
  • Act as the liaison between the client/broker/member and Allied Executives and Various Departments.
  • Troubleshoot, identify, and collaborate to optimize internal processes within Enhanced Case Management and the various Allied departments.
  • Other duties as assigned.

EDUCATION
  • Bachelor's degree or equivalent work experience required.

EXPERIENCE AND SKILLS
  • 2 years of experience with Group Health Insurance and Self-Funded Health Plans required.
  • Excellent verbal and written communication skills.
  • Excellent interpersonal and customer service skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Ability to review information, assess the problem, and propose viable solutions.
  • Strong analytical and problem-solving skills.
  • Medicare, Medicaid, Case Management and prescription drug benefit experience preferred.
  • Experience in a clinical or social work position a plus.
  • Experience working in a hospital system a plus.
  • Life and Health Insurance Producers License is preferred, but not required.
  • Proficient with Microsoft Office Suite or related software.

POSITION COMPETENCIES
  • Accountability
  • Analytical Thinking
  • Collaboration
  • Communication
  • Customer Focus
  • Functional Expertise
  • Initiative

PHYSICAL DEMANDS
  • This is a standard desk role requiring extended sitting and computer work.
  • Ability to communicate via telephone.

WORK ENVIRONMENT
  • Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.

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