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Remote Insurance Nurse Jobs in Riverside, CA (NOW HIRING)

Inspire Healthcare

Medical Director Physician

Pomona, CA · Remote

$250K - $350K/yr

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and ... Collaborate with nurses, physicians, and care management teams to support high-quality, cost ...

Gallagher

Claims Assistant

Corona, CA · Remote

$19.25 - $24.50/hr

Overview This is a remote position based in California, and candidates must reside within the state ... Keenan is a leading insurance brokerage and consulting firm serving hospitals, public agencies, and ...

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All JobsInsurance Nurse JobsRemote Insurance Nurse JobsRemote Insurance Nurse Jobs in Riverside, CA

Remote Insurance Nurse information

See Riverside, CA salary details

$24.5K

$61.7K

$101.7K

How much do remote insurance nurse jobs pay per year?

As of Jul 14, 2026, the average yearly pay for remote insurance nurse in Riverside, CA is $61,651.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,300.00 and $80,900.00 per year, depending on experience, location, and employer.

What are the typical daily tasks and workflow for a Remote Insurance Nurse?

As a Remote Insurance Nurse, your daily tasks often include reviewing and evaluating medical records for insurance claims, conducting telephonic patient interviews, and collaborating with physicians or underwriters to clarify medical information. You'll use digital platforms to document your findings, communicate with clients or policyholders, and submit detailed reports for claims processing or case management. Most remote insurance nurses work independently but interact regularly with a team via virtual meetings and secure messaging. This structure offers flexibility and autonomy, while also requiring diligence and steady communication to ensure accuracy and regulatory compliance.

What is a Remote Insurance Nurse job?

A Remote Insurance Nurse is a licensed nurse who works for an insurance company to assess medical claims, review patient records, and ensure proper care management—all from a remote setting. They may conduct telephonic assessments, verify medical necessity for treatments, or assist with case management. This role helps insurers make informed decisions about coverage, care coordination, and cost efficiency. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this position.

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

To excel as a Remote Insurance Nurse, you must have a valid RN license, thorough clinical experience, and strong knowledge of medical terminology and insurance procedures. Familiarity with health information management systems, telehealth platforms, and secure digital communication tools is important, as well as certifications like CCM (Certified Case Manager) if required. Outstanding critical thinking, attention to detail, and interpersonal communication skills are essential for evaluating claims and guiding clients through insurance processes. These competencies ensure accurate assessments, effective client support, and compliance with regulatory standards while working independently from a remote setting.

What are the most commonly searched types of Insurance Nurse jobs in Riverside, CA? The most popular types of Insurance Nurse jobs in Riverside, CA are:
What are popular job titles related to Remote Insurance Nurse jobs in Riverside, CA? For Remote Insurance Nurse jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Nurse jobs in Riverside, CA look for? The top searched job categories for Remote Insurance Nurse jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Insurance Nurse jobs? Cities near Riverside, CA with the most Remote Insurance Nurse job openings:
Remote Insurance Nurse jobs near you
Medical Director Physician

Medical Director Physician

Inspire Healthcare

Pomona, CA • Remote

$250K - $350K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the LAarea and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

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