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Remote Nurse Reviewer Jobs in Rialto, CA (NOW HIRING)

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

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Remote Nurse Reviewer information

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$37

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How much do remote nurse reviewer jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote nurse reviewer in Rialto, CA is $37.14, according to ZipRecruiter salary data. Most workers in this role earn between $34.23 and $41.44 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.

What are popular job titles related to Remote Nurse Reviewer jobs in Rialto, CA?

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

What job categories do people searching Remote Nurse Reviewer jobs in Rialto, CA look for?

The top searched job categories for Remote Nurse Reviewer jobs in Rialto, CA are:

What cities near Rialto, CA are hiring for Remote Nurse Reviewer jobs?

Cities near Rialto, CA with the most Remote Nurse Reviewer job openings:

Infographic showing various Remote Nurse Reviewer job openings in Rialto, CA as of August 2026, with employment types broken down into 2% As Needed, 65% Full Time, 11% Part Time, and 22% Contract. Highlights an 88% Physical, and 12% Remote job distribution, with an average salary of $77,247 per year, or $37.1 per hour.

Full-Time Licensed Clinical Social Worker - Remote Position

Divine Mercy Behavioral Health Center

Riverside, CA โ€ข Remote

Full-time

Medical, Retirement, PTO

Posted 5 days ago


Job description

Position Overview

Divine Mercy Behavioral Health Center is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our dynamic outpatient team. This full-time, remote position offers skilled professionals the opportunity to provide exceptional mental health services to our diverse patient population from the comfort of their own home.

About the Organization

At Divine Mercy Behavioral Health Center, our mission is to provide accessible and effective mental health care to the Riverside, California community. We pride ourselves on being a community health clinic that focuses not only on treatment but also on the holistic well-being of our patients. Our team collaborates to create a supportive environment that fosters personal growth and recovery, utilizing evidence-based practices to achieve the best outcomes.

Work Environment

As a remote professional, you will work closely with a team of healthcare providers, including psychiatrists, psychologists, and nursing staff, all committed to ensuring our patients receive comprehensive care. Although you will be working from home, you will have regular virtual interactions with your colleagues, participate in staff meetings, and receive ongoing clinical supervision to enhance your skills and professional development.

Key Responsibilities
  • Conduct thorough initial assessments for new patients, gathering detailed information to inform treatment decisions.
  • Develop personalized treatment plans that address the unique mental health needs of each patient, incorporating evidence-based techniques.
  • Provide individual and group psychotherapy sessions, utilizing various therapeutic modalities to treat conditions such as anxiety, depression, PTSD, and more.
  • Conduct crisis interventions when necessary, applying appropriate techniques and coordinating care with emergency services as needed.
  • Maintain accurate and up-to-date documentation of patient progress, treatment plans, and interventions using electronic medical records (EMR).
  • Collaborate with interdisciplinary team members, facilitating case discussions and care coordination to optimize patient treatment.
  • Participate in regular staff meetings, contributing to discussions on clinical challenges and sharing insights on case management.
  • Engage in ongoing professional development, remaining current with advancements in mental health practices and integrating new research findings into your work.
Patient Population / Client Focus

Our clinic caters to a wide range of patients, including children, adolescents, and adults facing various mental health challenges. You will have the opportunity to engage with individuals from diverse socio-economic backgrounds, providing culturally competent care tailored to their specific needs and circumstances.

Qualifications
  • A Masterโ€™s degree in Social Work (MSW) from an accredited program.
  • A current and valid California license as a Licensed Clinical Social Worker (LCSW).
  • Proven experience in providing psychotherapy and psychosocial assessments to a varied patient demographic.
  • Strong interpersonal, communication, and active listening skills, with the ability to build rapport and trust with patients.
  • Familiarity with electronic medical records and the ability to utilize technology effectively in a remote setting.
  • Commitment to evidence-based practices and participation in continuous education and training.
Preferred Experience
  • Experience in a community health setting or outpatient mental health clinic is highly desirable.
  • Knowledge of specific therapeutic modalities, such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or trauma-informed care.
  • Proficiency in utilizing telehealth platforms to deliver care effectively.
Compensation and Benefits

The salary for this position ranges from USD 80,000 to 100,000 per year. In addition to competitive pay, we offer a comprehensive benefits package that includes health insurance, retirement plans, paid time off, and professional development opportunities.

Career Growth Opportunities

At Divine Mercy Behavioral Health Center, we are dedicated to the professional advancement of our staff. You will have access to regular training sessions, workshops, and potential for advancement into supervisory or specialized clinical roles, allowing for personal and professional growth.

Why Join Our Team

If you are a Licensed Clinical Social Worker who is passionate about making a difference in the lives of individuals dealing with mental health challenges, we encourage you to apply. By joining the Divine Mercy Behavioral Health Center, you will play an integral role in providing exemplary care that empowers our patients towards recovery while working in a supportive team environment.

Application Information

To apply for this exciting opportunity, please submit your resume and a cover letter detailing your qualifications and interest in the position. We look forward to reviewing your application and potentially welcoming you to our dedicated team!