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Remote Clinical Reviewer Jobs in Puerto Rico (NOW HIRING)

LifeLink

Remote Administrator on Call PR

Guaynabo, PR · On-site +1

... clinical management, allocation, recovery, and overall coordination of donor-related actions. The ... Engages in review, education, and required organizational meetings to promote best practice sharing ...

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site +1

Process cases and request/maintain clinical documentation and transmit timely determinations via ... Remote/hybrid experience preferred * A minimum of 2-4 years' administrative experience and/or ...

OncoHealth

Case Review Representative

Guaynabo, PR · On-site +1

$13 - $15/hr

Remote/hybrid work experience preferred * A minimum of 2 years of healthcare related administrative ... Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation ...

Deloitte

Accounts Receivable Analyst

San Juan, PR · Remote

$23.50 - $30/hr

... remote client service delivery. Recruiting for this role ends on 08/01/2026 Work you'll do As an ... clinical teams as needed. * Review payments, contractual adjustments, denials, and patient ...

Deloitte

Hospital Billing Operator

San Juan, PR · Remote

$18 - $23/hr

This is a primarily remote role supporting an enterprise Epic implementation, with minimal travel ... Review patient accounts, charge details, coding inputs, and supporting documentation for billing ...

Deloitte

Hospital Billing Coordinator

San Juan, PR · Remote

$50K - $60K/yr

This is a primarily remote role supporting enterprise Epic implementation, with minimal travel and ... Review patient accounts, charge details, coding inputs, and supporting documentation for billing ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

DaVita

Regional Operations Director (ROD)

San Juan, PR · Remote

This is a field-based/remote position. Candidates can reside in Newport News, Hampton, Norfolk ... Review, analyze, and address gaps in service excellence, policies, and/or procedures proactively ...

All JobsClinical Reviewer JobsRemote Clinical Reviewer JobsRemote Clinical Reviewer Jobs in Puerto Rico

Remote Clinical Reviewer information

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 are popular job titles related to Remote Clinical Reviewer jobs in Puerto Rico? For Remote Clinical Reviewer jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Remote Clinical Reviewer jobs in Puerto Rico look for? The top searched job categories for Remote Clinical Reviewer jobs in Puerto Rico are:
What cities in Puerto Rico are hiring for Remote Clinical Reviewer jobs? Cities in Puerto Rico with the most Remote Clinical Reviewer job openings:
Remote Clinical Reviewer jobs near you
Infographic showing various Remote Clinical Reviewer job openings in Puerto Rico as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.
Remote Administrator on Call PR

Remote Administrator on Call PR

LifeLink

Guaynabo, PR • On-site, Remote

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 11 days ago

Job description

As a Remote Administrator on Call, you will directly contribute to LifeLink's life-saving mission. The Remote Administrator-on-Call (Remote AOC) supports recovery services staff by overseeing activities related to donor assessment and recovery. Activities requiring direct oversight include, but are not limited to, identification, evaluation, approach, clinical management, allocation, recovery, and overall coordination of donor-related actions. The Remote Administrator-on-Call (Remote AOC) supports recovery services staff by overseeing activities related to donor assessment and recovery. Activities requiring direct oversight include, but are not limited to, identification, evaluation, approach, clinical management, allocation, recovery, and overall coordination of donor-related actions.
Key Responsibilities:
  • Works closely with the Referral Coordinator (RC) in the utilization of available staff and resources with the goal of providing the highest level of support and customer service to referring hospitals and organizations.
  • Maintains awareness of all active donors and referrals expected to provide the legal-next-of-kin with disclosure of donation status or approach for organ and tissue donation, ensuring use of appropriate resources.
  • Provides real-time direction and guidance to staff for identification, evaluation, authorization, clinical management, organ allocation, and surgical recovery directed towards maximizing every organ donation opportunity.
  • Proactively engages with staff to provide thorough, in-depth guidance utilizing highly developed clinical expertise and advanced knowledge of the organ donation process. Advises staff when working through operational challenges by providing mentoring, talking points, and coaching.
  • Participates in performance improvement initiatives, identifying trends and supporting formal staff education needs including involvement in regular case activity reviews.
  • Engages in review, education, and required organizational meetings to promote best practice sharing and interdepartmental collaboration.
  • Provides regulatory oversight and verification of critical aspects of the donation process such as brain death documentation, hemodilution, additional risk status, infectious disease testing results, allocation variances, and transplant center/surgeon issues.
  • Performs other duties as assigned.

Who You Are
  • Passionate about helping others and making a difference
  • Aligned with LifeLink's core values of Compassion, Excellence, Legacy, People, and Quality
  • Bachelor's degree or equivalent combination of education, management and/or AOC.
  • Minimum of three years' experience as procurement organization clinical coordinator or two years in management and/or AOC.
  • Advanced knowledge of human anatomy and medical terminology, organ perfusion, strong decision- making capabilities, and strong attention to detail.
  • Remain current on all LifeLink and OPTN policies, CMS regulations, and relevant state and federal laws.
  • Excellent verbal and written communication and customer service skills.
  • Ability to work within a high-paced and elevated stress environment due to the nature of work involving death and dying causing emotional and physical stressors.
  • Ability to prioritize remote work (computer and smart phone) to accomplish the goals for all active donors and referrals with the goal of meeting the needs of all stakeholders.
  • A collaborator who thrives in a mission-first environment

Why LifeLink?
  • Be part of an organization with a legacy of saving lives and giving hope
  • Join a passionate and supportive team across Florida, Georgia, and Puerto Rico
  • COMPANY PAID Medical, Dental, Disability & Life Insurance
  • Generous COMPANY PAID Pension Plan for your Retirement
  • Paid Vacation, Sick Days & Holidays
  • Growth opportunities in a mission-driven, high-impact nonprofit
  • Work with purpose, knowing your efforts directly touch lives

Diversity, Equity & Inclusion
LifeLink is proud to be an equal opportunity employer. We celebrate diversity and are committed to building an inclusive environment that reflects the communities we serve.
Ready to Help Change Lives?
Your next career move could be the most meaningful one yet.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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