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Ageatia Global Solutions

Nurse, Clinical Appeals

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal ... The role is fully remote and requires an active Registered Nurse (RN) license. Key Responsibilities

Comagine

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Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission ... We go beyond merely providing a remote work option; we support and embrace it. We offer ...

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The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider appeals regarding adverse coverage decisions and grievances. The Clinical Appeals Nurse utilizes ...

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How much do remote clinical nurse jobs pay per year?

As of Aug 7, 2026, the average yearly pay for remote clinical nurse in the United States is $89,949.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,000.00 and $104,500.00 per year, depending on experience, location, and employer.

What does a typical workday look like for a remote clinical nurse?

A typical workday for a Remote Clinical Nurse involves reviewing patient records, conducting virtual patient assessments via video or phone, providing education and support, and coordinating care with physicians or other healthcare providers. You may also triage patient concerns, manage follow-ups, and document all interactions in electronic health records. While you’ll be working independently from a home office, frequent virtual collaboration with team members and participation in remote meetings are common. The role requires a balance of self-management and teamwork to ensure continuous, quality patient care. Flexibility and strong organizational skills help Remote Clinical Nurses adapt to varying caseloads and patient needs throughout the day.

What are the key skills and qualifications needed to thrive as a remote clinical nurse?

To thrive as a Remote Clinical Nurse, you need a valid RN license, clinical nursing experience, and the ability to make informed decisions while working independently. Familiarity with telehealth platforms, secure messaging systems, and electronic health records (EHRs) is important, as well as up-to-date certifications such as BLS or ACLS. Strong communication skills, time management, and empathy are vital for building rapport with patients and collaborating remotely with healthcare teams. These skills ensure accurate patient assessments and quality care delivery, even without in-person interactions.

What is a remote clinical nurse?

A Remote Clinical Nurse provides patient care, education, and support through phone or digital communication instead of in-person visits. They may work for healthcare systems, insurance companies, or telehealth providers, assisting with triage, case management, patient education, or chronic disease monitoring. This role requires strong clinical judgment, communication skills, and the ability to work independently while ensuring high-quality patient care.

More about Remote Clinical Nurse jobs
What cities are hiring for Remote Clinical Nurse jobs? Cities with the most Remote Clinical Nurse job openings:
What are the most commonly searched types of Clinical Nurse jobs? The most popular types of Clinical Nurse jobs are:
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Remote Clinical Nurse jobs near you
Infographic showing various Remote Clinical Nurse job openings in the United States as of August 2026, with employment types broken down into 83% Full Time, and 17% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,949 per year, or $43.2 per hour.

Nurse, Clinical Appeals

Ageatia Global Solutions

Remote

Other

Posted 4 days ago

Job description

Clinical Appeals Nurse

We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory knowledge, and strong communication skills to ensure all responses meet State and Federal compliance requirements. The role is fully remote and requires an active Registered Nurse (RN) license.

Key Responsibilities
  • Investigate and interpret written appeals from members, providers, attorneys, and other stakeholders
  • Craft original response letters based on corporate policy and regulations
  • Ensure compliance with all applicable State and Federal mandates
  • Compile and organize relevant clinical, contractual, and policy documentation
  • Formulate case summaries and recommendations
  • Communicate final decisions post-physician review, including external appeal rights
  • Evaluate medical and behavioral health appeal requests using clinical expertise
  • Interpret regulatory/accreditation guidelines to ensure proper case handling
  • Collaborate with Independent Review Organizations and panel physicians
  • Address complaints from CMS and other regulatory bodies
  • Maintain up-to-date knowledge of medical, psychiatric, surgical, and diagnostic terminology
  • Understand complications and comorbidities related to medical and behavioral health conditions
Required Qualifications
  • High School Diploma (or equivalent)
    • 2 years in medical-surgical or similar clinical setting
    • OR 3 years in mental health/psychiatric care
  • RN – Registered Nurse, with active State or Compact Licensure (Required)
Preferred Qualifications
  • Experience with Medical Review, Utilization Management, or Case Management at a Managed Care Organization (MCO) or hospital
  • BSN or MSN degree preferred
  • CCM (Certified Case Manager) – Preferred
  • LNCC (Legal Nurse Consultant Certified) – Preferred
Key Skills and Competencies

Medical terminology & procedural knowledge - Advanced

Appeals process & regulatory guidelines - Proficient

Verbal & written communication - Proficient

Customer service and stakeholder communication - Advanced

Critical thinking and analytical assessment - Proficient

Microsoft Office Suite (Word, Excel, Outlook) - Proficient

Understanding of behavioral health and substance abuse treatment - Proficient

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About Ageatia Global Solutions

Sourced by ZipRecruiter

Ageatia Global Solutions, located in Schaumburg, IL, US, is a reputable IT consultant company that offers a range of premium technical and IT staffing services across numerous industries. Its official website, ageatia.com, is a testament to its dedication to top-tier delivery. Since its inception in 2002, Ageatia has consistently provided optimal services specific to each client's needs. Ageatia's core competency lies in identifying and delivering expert engineers and IT professionals on contract and permanent placements. The company is known for maintaining a business model that ultimately focuses on solving client's workforce challenges. Ageatia's mission is to provide companies with the most skilled set of candidates, while also offering advancing opportunities to potential employees.

Industry

It services

Company size

51 - 200 Employees

Headquarters location

Schaumburg, IL, US

Year founded

2002

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