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Remote Nurse Reviewer Jobs (NOW HIRING)

Paradigm Information Services, Inc.

$30 - $38/hr

This is a remote position. Paradigm is seeking an experienced Nurse Reviewer to support our client in a detail-oriented role combining subject-matter expertise, data review, problem solving, client ...

New

Elevance Health

Nurse Reviewer I

$35.54 - $55.73/hr

Nurse Reviewer I Nurse Reviewer I Seeking RNs that have a current, unrestricted RN license in either the state of Illinois and/or California. Location: Virtual - This role enables associates to work ...

Angel City VA

Remote Nurse

Remote Nurse Position: Remote Nurse Employment Type: Part-Time to Full-Time (flexible transition) Compensation: $7 USD per hour Location: Remote (work from home) About the Role We are seeking a ...

Dane Street, LLC

Registered Nurse Reviewer

Dane Street has embarked on a program where we are looking for Registered Nurses to perform reviews and clinical summaries for disability claims. The expected report turnaround time for the reviewer ...

Peraton

Nurse Reviewer - Medicaid

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Peraton

Nurse Reviewer - Medicaid

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Peraton

Bilingual Nurse Reviewer - Medicaid

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Peraton

Bilingual Nurse Reviewer - Medicaid

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

BreatheSuite

Remote Nurse Practitioner

Denver, CO · Remote

Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions

Dane Street

PRN Utilization Review Nurse Reviewer

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

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Remote Nurse Reviewer information

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How much do remote nurse reviewer jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for remote nurse reviewer in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What is a remote nurse reviewer?

Remote Nurse Reviewers are registered nurses who assess medical records, insurance claims, or healthcare documentation from a remote location, typically from home. They play a crucial role in ensuring that patient care meets established guidelines and that services billed to insurance are medically necessary and appropriately documented. Their work often involves collaborating with physicians, insurance companies, and healthcare providers to review cases, determine coverage, and support utilization management. This position requires strong clinical knowledge, attention to detail, and proficiency with electronic health records and telecommunication tools.

What does a remote nurse reviewer do?

As a remote nurse reviewer, you work from home to conduct pre-authorization, check out-of-network benefit information, and determine treatment appropriateness, along with other reviewing responsibilities. In this role, you follow clinical and departmental guidelines when reviewing documents to determine if the treatment used was needed and appropriate. Your duties are to consider medical necessity clinical screenings, determine if medical necessity criteria are met for the patient, communicate with insurance companies for pre-authorization, notify physicians about insurance decisions, and document all reviews. You make phone calls and examine the record from home, allowing you to work a flexible schedule.

What are the key skills and qualifications needed to thrive as a remote nurse reviewer, and why are they important?

To thrive as a Remote Nurse Reviewer, you need a current RN license, clinical experience, and a strong understanding of medical terminology and healthcare regulations. Familiarity with utilization review platforms, electronic health records (EHRs), and coding systems such as ICD-10 and CPT is typically required. Exceptional attention to detail, critical thinking, and effective written communication skills help you stand out in this role. These competencies are vital to ensuring accurate medical reviews, regulatory compliance, and clear communication with providers and payers in a remote work environment.

What are some common challenges faced by remote nurse reviewers, and how can they be managed?

Remote Nurse Reviewers often encounter challenges such as balancing productivity with quality, adapting to frequent changes in healthcare regulations, and managing communication across virtual teams. To manage these, it's important to stay organized, participate in ongoing training, and utilize digital collaboration tools effectively. Regular check-ins with supervisors and colleagues can also help maintain connection and clarity on case review expectations, ensuring both accuracy and efficiency in your work.

What is the difference between Remote Nurse Reviewer vs Remote Medical Coder?

AspectRemote Nurse ReviewerRemote Medical Coder
Required CredentialsRN license, clinical experienceCertification (CPC, CCS), coding training
Work EnvironmentHealthcare organizations, insurance companiesHospitals, billing companies, insurance firms
Industry UsageMedical review, claims assessmentMedical billing, coding, reimbursement
Search/Comparison IntentUnderstanding clinical review rolesUnderstanding coding and billing roles

Remote Nurse Reviewers primarily evaluate medical records to ensure accuracy and compliance, requiring nursing credentials and clinical experience. Remote Medical Coders focus on translating medical procedures into billing codes, requiring coding certifications. Both roles are remote, serve healthcare and insurance industries, but differ in daily tasks and required qualifications.

More about Remote Nurse Reviewer jobs

What cities are hiring for Remote Nurse Reviewer jobs?

Cities with the most Remote Nurse Reviewer job openings:

What states have the most Remote Nurse Reviewer jobs?

States with the most job openings for Remote Nurse Reviewer jobs include:

What are popular job titles related to Remote Nurse Reviewer jobs?

For Remote Nurse Reviewer jobs, the most frequently searched job titles are:

Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in the United States as of September 2026, with employment types broken down into 4% As Needed, 58% Full Time, 14% Part Time, and 24% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Nurse Reviewer

Remote

Paradigm Information Services, Inc.
Recruiting and Staffing Services • 51 - 200 employees
Learn more about Paradigm Information Services, Inc.external

$30 - $38/hr

Contractor

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

Job description

This is a remote position.

Paradigm is seeking an experienced Nurse Reviewer to support our client in a detail-oriented role combining subject-matter expertise, data review, problem solving, client service, and process improvement.

The ideal candidate brings experience in nursing, healthcare, or a related specialized field and is comfortable interpreting information, resolving complex issues, preparing accurate documentation, and working collaboratively across teams. This position is well suited for someone who can work independently, exercise sound judgment, meet critical deadlines, and serve as a knowledgeable resource to colleagues and internal or external clients

Type: 3-month contract, with potential for extension
Pay: $31–$38/hour, based on experience and credentials
Benefits: Medical, dental, vision, life, 401(k), PTO, and sick leave
Location: Alabama, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington DC, Wisconsin
Job No.: Para_1497

As a Nurse Reviewer, you will:
  • Apply subject-matter expertise to review information, interpret and synthesize data, and make recommendations that support team and program objectives.
  • Provide excellent service and support to internal and external clients.
  • Prepare required reports, documentation, and other program materials accurately and within established deadlines.
  • Research and resolve technical, procedural, and subject-matter issues.
  • Serve as a knowledgeable resource for assigned projects and assist with escalated or complex matters.
  • Collaborate with colleagues and other departments to identify issues, coordinate service delivery, and meet client needs.
  • Identify opportunities to improve processes, workflows, and overall team effectiveness.
  • Help develop, document, and implement departmental procedures and standard operating procedures (SOPs).
  • Support the planning and execution of special projects and departmental initiatives.
  • Assist management with escalations and serve as an initial escalation resource for junior team members when appropriate.
  • Assist with training and knowledge sharing across the team.
  • Participate actively in meetings and contribute to collaborative problem solving.
  • Protect confidential and sensitive information and follow applicable procedures and security requirements.

Requirements
You bring:
  • Bachelor's degree in a relevant field or an equivalent combination of education and related work experience; a nursing degree is preferred.
  • 3+ years of experience in a specialized area relevant to the position.
  • Strong analytical and problem-solving skills, including the ability to interpret information and recommend appropriate action.
  • Excellent written and verbal communication skills.
  • Strong internal and external client-service skills.
  • Ability to manage priorities and meet critical deadlines in a changing environment.
  • Ability to work effectively both independently and collaboratively as part of a team.
  • Sound judgment and the ability to identify and escalate issues.
  • Proficiency with Microsoft Office Suite.
Additional Requirement: Candidates must successfully complete the MRR assessment to be considered for an interview.


Benefits
Paradigm offers medical, dental, vision, life, 401K, PTO, and sick days.

About Us, Paradigm

Paradigm Information Services is an established staffing company that has been connecting talented people with great opportunities for more than 25 years. We work with clients across a variety of industries and positions, giving our recruiting team the opportunity to work on interesting and sometimes challenging searches.

Paradigm Information Services does not discriminate on the basis of race, sex, color, religion, age, national origin, marital status, disability, veteran status, genetic information, sexual orientation, gender identity or any other reason prohibited by law in provision of employment opportunities and benefits.