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Remote Nurse Reviewer Jobs in Raleigh, NC (NOW HIRING)

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Remote Nurse Reviewer information

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$27

$35

$41

How much do remote nurse reviewer jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for remote nurse reviewer in Raleigh, NC is $36.00, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $40.19 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
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What cities near Raleigh, NC are hiring for Remote Nurse Reviewer jobs? Cities near Raleigh, NC with the most Remote Nurse Reviewer job openings:
Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in Raleigh, NC as of July 2026, with employment types broken down into 84% Full Time, 4% Part Time, and 12% Contract. Highlights an 100% Remote job distribution, with an average salary of $74,879 per year, or $36 per hour.

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

3:15

Raleigh, NC • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago

Job description

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team works fervently to anticipate the needs of our patients and connect on a personal level. We exist to coach people to their best health!


Responsibilities:
  • Welcome patients into continuous care program(s) and review benefits and services included
  • Educate patients on the frequency and use of their assigned in-home monitoring devices
  • Create a personalized, comprehensive care plan with the patient via phone or video visits
  • Identify and address any barriers to patient success
  • Provide specific education and coaching on patients' chronic conditions
  • Connect with the patient frequently to review readings and a monthly update of their plan of care
  • Serve as the patient's first contact for all non-emergent needs (example - medication refills, scheduling, appointment reminders, etc.)
  • Anticipate patients' needs and bridge any gaps in care
  • Assist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.).
  • Review and evaluate in-home device readings in real time, during normal business hours
  • Follow established protocols for identifying, communicating and documenting device trends and any associated symptoms in the patient's medical record
  • Escalate concerning readings and/or symptoms to the provider following a communication protocol established by the provider
  • Establish a meaningful rapport that builds trust, open communication, and motivation to make a positive change in the patient's health
  • Collaborate with virtual team members and in-office staff to ensure patient's needs are being met

Requirements

  • Active and Unrestricted Georgia RN License (Compact License preferred)
  • At least three (3) years of experience in adult health preferred
  • Background in adult chronic health conditions (Medical Surgical, Outpatient/Clinic, Care Management) preferred
  • Variety of Electronic Medical Record (EMR) experience
  • Proficient knowledge, skill, and interest in basic computer skills
  • Proficient in problem solving and ability to multi-task
  • Excellent communication skills (oral and written)
  • Excellent teamwork skills
  • Clean background check and drug screening
  • Comfortable working remotely but collaboratively


Please note our interview process: application reviewed, one way video interview, workplace personality assessment, interview through Microsoft Teams, offer extended if applicable

Benefits

  • Health Care Plan (Medical, Dental & Vision)
  • Retirement Plan (401k, IRA)
  • Life Insurance (Basic, Voluntary & AD&D)
  • Paid Time Off (Vacation, Sick & Public Holidays)
  • Training & Development
  • Work From Home
  • Full Time, Salaried 55-65k