ZipRecruiter

Log In

2

Remote Clinical Reviewer Jobs in Tennessee (NOW HIRING)

NHC HomeCare - Murfreesboro

Coder

Murfreesboro, TN · Remote

Definition: Remote Clinical Coder and Quality Review for the Home Care division. Line of Authority: Director of Coding Education and Compliance, Home Care; Director of Home Care Services ...

next page

Showing results 1-20

All JobsClinical Reviewer JobsRemote Clinical Reviewer JobsRemote Clinical Reviewer Jobs in Tennessee

Remote Clinical Reviewer information

See Tennessee salary details

$22

$32

$42

How much do remote clinical reviewer jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for remote clinical reviewer in Tennessee is $32.60, according to ZipRecruiter salary data. Most workers in this role earn between $28.37 and $36.63 per hour, depending on experience, location, and employer.

What is a remote clinical reviewer?

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 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.

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.

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 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.

More about Remote Clinical Reviewer jobs

What are popular job titles related to Remote Clinical Reviewer jobs in Tennessee?

For Remote Clinical Reviewer jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Remote Clinical Reviewer jobs in Tennessee look for?

The top searched job categories for Remote Clinical Reviewer jobs in Tennessee are:

What cities in Tennessee are hiring for Remote Clinical Reviewer jobs?

Cities in Tennessee with the most Remote Clinical Reviewer job openings:

Remote Clinical Reviewer jobs near you
Infographic showing various Remote Clinical Reviewer job openings in Tennessee as of August 2026, with employment types broken down into 87% Full Time, 6% Part Time, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $67,805 per year, or $32.6 per hour.

Clinical Review Specialist - AI Trainer

Nashville, TN • Remote

Mercor
See more jobs at Mercorexternal

$105/hr

Full-time

Posted 10 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Prior Authorisation Manager
Type: Contract
Compensation: $105/hour
Location: Remote

Role Responsibilities

  • Manage end-to-end prior authorisation workflows for medical and clinical services across multiple payer types.
  • Review clinical documentation to assess medical necessity against InterQual, MCG, or payer-specific criteria.
  • Evaluate AI-generated prior authorisation recommendations and clinical justification drafts for accuracy and appropriateness.
  • Coordinate with clinical staff, physicians, and payers to obtain timely authorisation approvals.
  • Track authorisation status, denials, and appeal outcomes to identify workflow improvement opportunities.
  • Annotate AI outputs and provide structured clinical feedback to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in prior authorisation, utilisation management, or clinical review, with at least 2 years in a management role.
  • Strong clinical background with knowledge of medical necessity criteria (InterQual, MCG, or equivalent).
  • Deep familiarity with commercial, Medicare Advantage, and Medicaid prior authorisation requirements.
  • Experience managing authorisation workflows across multiple specialities and service types.
  • Proficiency with authorisation management systems and EHR platforms (Epic, Cerner, or equivalent).
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to critically evaluate clinical documentation and AI-generated outputs.

Preferred

  • Clinical licensure (RN, LPN, or equivalent) or relevant certification (CPUR, CPUM).
  • Experience with appeals and peer-to-peer review processes.
  • Familiarity with CMS prior authorisation rules and the No Surprises Act.
  • Background in physician office, hospital, or health plan prior authorisation operations.
  • Familiarity with AI tools and comfort evaluating AI-generated clinical content.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.


#hiringmercor