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Remote Clinical Appeals Nurse Jobs in Washington

DataAnnotation

Clinical Appeals Nurse

Annapolis, MD · Remote

$50/hr

We are looking for a Clinical Appeals Nurse to join our team to train AI models. You will measure ... Benefits Full-time or part-time remote position Choose which projects you want to work on Flexible ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Ashburn, VA · On-site +1

$58.50 - $71.25/hr

... clinical rationales to support appeal determinations. * Collaborate with physicians, nurses, and ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Annandale, VA · On-site +1

$57 - $69.50/hr

... clinical rationales to support appeal determinations. * Collaborate with physicians, nurses, and ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Pasadena, MD · On-site +1

$58.25 - $70.75/hr

... clinical rationales to support appeal determinations. * Collaborate with physicians, nurses, and ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Silver Spring, MD · On-site +1

$59 - $72/hr

... clinical rationales to support appeal determinations. * Collaborate with physicians, nurses, and ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Vheda Health

Clinical Support Specialist

Columbia, MD · On-site +1

$40K - $70K/yr

As a Remote Clinical Support Specialist, you will receive real-time data through remote patient ... Current and active RN license. * Minimum of 1-3 years of experience in a critical care setting.

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$62.3K

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How much do remote clinical appeals nurse jobs pay per year?

As of May 28, 2026, the average yearly pay for remote clinical appeals nurse in Washington is $107,082.00, according to ZipRecruiter salary data. Most workers in this role earn between $80,400.00 and $115,000.00 per year, depending on experience, location, and employer.

What is a Remote Clinical Appeals Nurse job?

A Remote Clinical Appeals Nurse is a licensed nurse who reviews denied medical claims and appeals decisions by insurance companies. They assess medical records, ensure treatments meet clinical guidelines, and provide supporting documentation to justify coverage. This role requires critical thinking, knowledge of medical policies, and strong communication skills to advocate for patients. Working remotely, these nurses collaborate with healthcare providers and insurance representatives to resolve disputes.

What are the key skills and qualifications needed to thrive in the Remote Clinical Appeals Nurse position, and why are they important?

To excel as a Remote Clinical Appeals Nurse, you need a current RN license, thorough clinical knowledge, strong analytical abilities, and experience in reviewing medical records. Familiarity with medical necessity criteria, utilization management systems, and payor portals as well as certification such as CCM or ACMA is highly valued. Excellent written communication, attention to detail, and the ability to work independently while managing multiple deadlines are key soft skills. These attributes are crucial for effectively advocating in appeals, ensuring compliance, and delivering timely, accurate case reviews from a remote setting.

What are the typical responsibilities of a Remote Clinical Appeals Nurse on a daily basis?

A Remote Clinical Appeals Nurse typically reviews denied medical claims, analyzes patient records against clinical guidelines, and prepares detailed written appeals to insurance payors. You may also coordinate with physicians, case managers, and other healthcare professionals to gather supporting documentation or clarification. The job requires regular use of healthcare software platforms, meeting strict appeal deadlines, and ensuring each case meets regulatory and organizational standards. Collaboration often occurs via email, video conferencing, or secure messaging, making strong communication skills vital for success in this virtual work environment.
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Remote Clinical Appeals Nurse jobs near you
Clinical Appeals Nurse

Clinical Appeals Nurse

DataAnnotation

Annapolis, MD • Remote

$50/hr

Full-time, Part-time, Contractor

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

Job description

We are looking for a Clinical Appeals Nurse to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. In this role, you will need to be an expert in healthcare.

We are interested in a wide range of expertise, so relevant backgrounds include Clinical Documentation & HIM, Medication Management (PharmD), Laboratory Medicine and Pathology Services (MLS, MD), Quality Improvement & Patient Safety, Regulatory Compliance, Accreditation & Medical Staff, Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work on Flexible schedule Projects are paid hourly starting at $50+ per hour Bonuses available for high-quality and high-volume work Responsibilities Provide AI chatbots with diverse and complex healthcare-related problems Evaluate AI outputs for logic, accuracy, and performance Ensure the medical accuracy and overall quality of model responses Qualifications Fluency in English (native or bilingual level) A current or in-progress medical or healthcare-related degree Notes: Payment is made via PayPal. We will never ask you for any money.

PayPal will handle any currency conversions from USD. Only applicants in the United States will be considered for this role. This is an independent contractor position.

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