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Remote Nurse Reviewer Jobs in Bothell, WA (NOW HIRING)

CHPW

Case Manager I (MSW/RN) Medicare/DSNP

Seattle, WA · On-site +1

$37.96 - $58.84/hr

This position is remote. We are targeting an individual who lives in the Seattle area and is ... Reviews and revises the plan of care with the interdisciplinary care team to reflect changing ...

PPGNHI

Clinical Director of Virtual Care Programs

Everett, WA · On-site +1

$88K - $120K/yr

... non-licensed remote staff (APC, RN, case managers, patient navigators). Ensure safe, timely ... Provide clinical direction, case review, and supervision for CFU APCs, CFU RNs, Telehealth ...

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Remote Nurse Reviewer information

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$41

$47

How much do remote nurse reviewer jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for remote nurse reviewer in Bothell, WA is $41.40, according to ZipRecruiter salary data. Most workers in this role earn between $38.17 and $46.20 per hour, depending on experience, location, and employer.

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 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 Remote Nurse Reviewers?

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 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.

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.
More about Remote Nurse Reviewer jobs
What are popular job titles related to Remote Nurse Reviewer jobs in Bothell, WA? For Remote Nurse Reviewer jobs in Bothell, WA, the most frequently searched job titles are:
What job categories do people searching Remote Nurse Reviewer jobs in Bothell, WA look for? The top searched job categories for Remote Nurse Reviewer jobs in Bothell, WA are:
What cities near Bothell, WA are hiring for Remote Nurse Reviewer jobs? Cities near Bothell, WA with the most Remote Nurse Reviewer job openings:
Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in Bothell, WA as of July 2026, with employment types broken down into 71% Full Time, and 29% Contract. Highlights an 100% Remote job distribution, with an average salary of $86,115 per year, or $41.4 per hour.

Utilization Review Nurse

Virginia Mason Medical Center

Seattle, WA • On-site, Remote

$52.03 - $101.24/hr

Other

Posted yesterday

New

Job description

Where You'll Work
Virginia Mason Franciscan Health brings together two award winning health systems in Washington state - CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.
Job Summary and Responsibilities
As our Utilization Review Nurse, you will ensure the medical necessity and appropriateness of care for all hospitalized patients, promoting fiscal responsibility and optimal patient outcomes. You will leverage specialized utilization review criteria, technologies, and tools to verify the correct level of care throughout their acute stay.
Every day you will perform meticulous clinical assessments, identify and coordinate cost-effective alternatives, and proactively support provider decision-making. You will collaborate with the healthcare team, patients, families, and both internal/external customers to achieve optimal outcomes efficiently and ethically, ensuring compliance with payer guidelines and regulatory standards.
To be successful in this role you will have strong analytical skills, persuasive communication, and a steadfast commitment to patient advocacy. Fiscal stewardship is crucial for navigating complex clinical and financial landscapes, ensuring appropriate resource utilization.
Job Requirements
Required
  • Bachelor's degree in Nursing and 3 years of professional nursing experience in a hospital setting.
  • Experience in utilization review.
  • Demonstrated ability to work collaboratively with all members of the care team (CNLs, MSWs, MDs) in conveyance of information that affects patient care.
  • An understanding of variable payor rules and regulations is also required.

Preferred
  • Knowledge of core insurance coverage guidelines and financial principles.
  • Acute care nursing experience.

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