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Remote Nurse Reviewer Jobs in Rio Rancho, NM (NOW HIRING)

firsthand Health

Remote Triage Nurse

Albuquerque, NM · On-site +1

$80K/yr

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support ... Such requests will be subject to review and approval by the Company, and exemptions will be granted ...

DataAnnotation

Registered Nurse - AI Trainer

Rio Rancho, NM · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

Scribe-X

Medical Scribe (Remote)

Albuquerque, NM · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Magellan Health, Inc.

Care Coordinator - NM

Albuquerque, NM · On-site +1

$17.50 - $23.75/hr

This position is remote within New Mexico. Coordinates care of individual clients with application ... Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and ...

All JobsNurse Reviewer JobsRemote Nurse Reviewer JobsRemote Nurse Reviewer Jobs in Rio Rancho, NM

Remote Nurse Reviewer information

See Rio Rancho, NM salary details

$26

$34

$40

How much do remote nurse reviewer jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for remote nurse reviewer in Rio Rancho, NM is $34.84, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $38.89 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 Rio Rancho, NM? For Remote Nurse Reviewer jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Remote Nurse Reviewer jobs in Rio Rancho, NM look for? The top searched job categories for Remote Nurse Reviewer jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Remote Nurse Reviewer jobs? Cities near Rio Rancho, NM with the most Remote Nurse Reviewer job openings:
Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 64% Full Time, 16% Part Time, and 20% Contract. Highlights an 100% Remote job distribution, with an average salary of $72,458 per year, or $34.8 per hour.
Remote Triage Nurse

Remote Triage Nurse

firsthand Health

Albuquerque, NM • On-site, Remote

$80K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Job description

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.
firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.
We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job-it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is primarily a day-shift role (8 hours/day, 8:30-4:30 PST), with occasional potential for nights or weekends. When not managing acute issues, Triage Nurses focus on care coordination, training, and related administrative tasks.
Responsibilities of a Triage Nurse include:
  • Triage and Escalation: Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately and escalate emergencies immediately.
  • Collaboration: Work closely with peer mental health workers, social workers, and APPs to address acute issues comprehensively.
  • Coordination: Coordinate care with patients' other providers to ensure seamless health management.
  • Training: Develop and deliver training on basic medical topics for peer mental health workers and social workers.
Triage Nurses should have:
  • Strong triage and prioritization skills, with the ability to rapidly assess and determine the appropriate level of care.
  • Problem-solving expertise with a creative, patient-centered approach.
  • Ability to provide condition-specific patient education and self-management guidance.
  • Adaptability to varying team cultures and processes.
  • Empathy, compassion, and approachability in patient and team interactions.
Required experience includes:
  • Active RN license through a Nurse Licensure Compact (NLC) state and willingness to obtain licensure in non-compact states.
  • Bachelor of Science in Nursing (BSN) or Associates of Nursing (ASN)
  • At least 3 years of Emergency Room (ER) experience
  • Experience working with populations facing challenges such as serious mental illness, behavioral health conditions, and/or substance use disorders
  • Care management and coordination experience.
Bonus Points for:
  • Psychiatric-Mental Health Nursing Certification (PMH-BC)
  • Washington state RN license

Base salary range:
$80,000-$80,000 USD
We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.
BenefitsFor full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.
Vaccination Policy
Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law.
New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.
Unfortunately, we are not able to offer sponsorship at this time.
firsthand Health will only contact candidates from email addresses ending in @firsthandcares.com. Any communication from another domain claiming to represent firsthand is fraudulent. We will never ask for payment or sensitive financial information during the hiring process. If you receive suspicious outreach, please do not respond.

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