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Remote Clinical Reviewer Jobs (NOW HIRING)

Astyra Corporation

Clinical Reviewer

Indianapolis, IN · Remote

$36 - $40/hr

Remote (U.S.-based) Licensure Requirement: Must hold an active clinical license in the State of ... Ensure accuracy and timeliness of all review cases in accordance with contract requirements

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How much do remote clinical reviewer jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for remote clinical reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

What are Remote Clinical Reviewers?

Remote Clinical Reviewers are healthcare professionals, often nurses or physicians, who evaluate medical records and treatment plans from a remote location to ensure they meet clinical guidelines and insurance requirements. They assess the necessity, appropriateness, and quality of care provided to patients, often working for insurance companies, healthcare organizations, or third-party review agencies. This role typically involves reviewing documentation, making recommendations, and communicating findings electronically or by phone. The position allows for flexible, home-based work while contributing to healthcare quality and compliance.

What is the difference between Remote Clinical Reviewer vs Remote Medical Reviewer?

AspectRemote Clinical ReviewerRemote Medical Reviewer
Required CredentialsRN, LPN, or other healthcare licenses; clinical experienceMD or DO license; medical degree; clinical experience
Work EnvironmentHome-based, healthcare organizations, insurance companiesHome-based, insurance companies, healthcare organizations
Employer & Industry UsageInsurance, healthcare providers, government programsInsurance, healthcare, legal medical review
Common Search & ComparisonYesYes

Remote Clinical Reviewers typically hold nursing or healthcare licenses and focus on reviewing clinical documentation and patient care. Remote Medical Reviewers usually have medical degrees and perform in-depth medical assessments, often for insurance claims or legal cases. Both roles are home-based and serve similar industries, but the Medical Reviewer requires a medical degree and broader clinical expertise.

How does a Remote Clinical Reviewer typically collaborate with other healthcare professionals while working offsite?

Remote Clinical Reviewers regularly coordinate with physicians, nurses, and case managers through secure digital platforms, such as video conferencing, email, and electronic health record systems. Despite working remotely, they are integral to interdisciplinary teams and often participate in virtual meetings to discuss patient cases, clarify documentation, and ensure compliance with clinical guidelines. Building strong communication skills and familiarity with collaboration tools is essential for success in this role, as frequent interaction with both internal teams and external providers is a common aspect of daily responsibilities.

What are the key skills and qualifications needed to thrive as a Remote Clinical Reviewer, and why are they important?

To thrive as a Remote Clinical Reviewer, you need a healthcare background such as RN, LPN, or other clinical licensure, along with strong knowledge of medical guidelines and utilization review processes. Familiarity with electronic medical record (EMR) systems, medical coding, and utilization management software is typically required. Attention to detail, analytical thinking, and clear written communication are crucial soft skills for reviewing patient cases and collaborating with remote teams. These skills and qualifications ensure accurate and timely clinical assessments, support compliance, and help facilitate appropriate patient care decisions in a virtual environment.

What Does a Remote Clinical Reviewer Do?

A remote clinical reviewer works from home reviewing medical records and claims for inpatient and outpatient services. Your responsibilities include executing a thorough review of patient medical records, submitting documentation to insurance companies, and ensuring accurate, timely, and secure processing of patient information. As a clinical reviewer, your duties span determining coverage for diagnosis and treatment, reviewing appeals, and processing correspondence. You provide remote support and expertise to department care coordinators, interact with teams and department heads as necessary, and request additional information for processing records as necessary.

More about Remote Clinical Reviewer jobs
What cities are hiring for Remote Clinical Reviewer jobs? Cities with the most Remote Clinical Reviewer job openings:
What states have the most Remote Clinical Reviewer jobs? States with the most job openings for Remote Clinical Reviewer jobs include:
What job categories do people searching Remote Clinical Reviewer jobs look for? The top searched job categories for Remote Clinical Reviewer jobs are:
Remote Clinical Reviewer jobs near you
Infographic showing various Remote Clinical Reviewer job openings in the United States as of May 2026, with employment types broken down into 73% Full Time, 17% Part Time, 1% Temporary, and 9% Contract. Highlights an 70% Physical, 3% Hybrid, and 27% Remote job distribution, with an average salary of $74,707 per year, or $35.9 per hour.
Clinical Reviewer

Clinical Reviewer

Astyra Corporation

Indianapolis, IN • Remote

$36 - $40/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 6 days ago

Job description

Job Summary

The purpose of this position is to utilize clinical expertise to review medical records against established criteria in accordance with contract requirements.

Location: Remote (U.S.-based)
Licensure Requirement: Must hold an active clinical license in the State of Indiana or a Compact State license

Work Schedule:

  • 40 hours per week - Friday, Saturday, Sunday, and two weekdays
  • Weekend and/or holiday availability required 

Training Requirement:

  • Must be fully available to attend 100% of training
  • Schedule: Monday–Friday, 9:00 AM – 6:00 PM EST
  • Duration: Minimum of 3 weeks
Key Responsibilities
  • Ensure accuracy and timeliness of all review cases in accordance with contract requirements
  • Manage daily workload and queues; adjust workflow as needed to meet departmental demands
  • Collaborate with Supervisor on quality monitoring and improvement activities
  • Maintain current knowledge of clinical practices and review processes
  • Serve as a liaison for providers regarding customer service issues and resolution
  • Perform various review types as assigned based on workload
  • Build and maintain professional relationships with internal and external stakeholders
  • Attend required trainings and team meetings
  • Cross-train to support business and client needs
  • Comply with all corporate policies, including HIPAA Privacy and Security regulations

Note: Responsibilities may evolve based on business needs.
 

Required Qualifications
  • Active, unrestricted LPN/LVN or RN license in Indiana or Compact State
  • Associate’s degree (Bachelor’s preferred) or diploma from an accredited nursing program
  • 2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization experience
  • 2+ years of medical necessity review experience
  • 1+ year of InterQual and/or Milliman Care Guidelines (MCG) experience
  • Strong knowledge of medical records, terminology, and disease processes
  • Excellent clinical assessment and critical thinking skills
  • Strong written and verbal communication skills
  • Ability to navigate multiple systems efficiently
  • Strong organizational skills and flexibility
Preferred Qualifications
  • 3+ years of clinical experience (acute care, behavioral health, and/or med-surgical)
  • Knowledge of NCQA and URAC standards
  • Experience working in a team-based environment
  • Proficiency in Microsoft Office
  • Strong time management and prioritization skills
  • Demonstrated ability to maintain confidentiality and ensure HIPAA compliance
Weekend and holiday flexibility is required
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
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