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Remote Nurse Reviewer Jobs in Rochester, NY (NOW HIRING)

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Remote Nurse Reviewer information

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$27

$36

$42

How much do remote nurse reviewer jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for remote nurse reviewer in Rochester, NY is $36.54, according to ZipRecruiter salary data. Most workers in this role earn between $33.70 and $40.82 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.

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The top searched job categories for Remote Nurse Reviewer jobs in Rochester, NY are:

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Cities near Rochester, NY with the most Remote Nurse Reviewer job openings:

Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in Rochester, NY as of August 2026, with employment types broken down into 56% Full Time, 18% Part Time, and 26% Contract. Highlights an 100% Remote job distribution, with an average salary of $76,007 per year, or $36.5 per hour.

Nurse Practitioner (Experienced) - Virtual Urgent Care

Rochester Regional Health

Rochester, NY • On-site, Remote

$100K - $150K/yr

Full-time

Re-posted 6 days ago

Key responsibilities

  • Assess and diagnose acute illnesses and minor injuries, and implement treatment plans.

  • Prescribe medication, provide health education and guidance, and refer patients to specialists or community resources.

  • Perform administrative tasks such as updating patient charts, managing test results, medication refills, and completing required documentation.

Rochester Regional Health rating

7.3

Company rating: 7.3 out of 10

Based on 221 frontline employees who took The Breakroom Quiz

305th of 898 rated healthcare providers

Job description

SUMMARY
The Nurse Practitioner in this role will play a pivotal role in delivering high-quality healthcare services to patients in a virtual, urgent care setting. This position combines clinical expertise with the convenience of telehealth technology to provide accessible and timely care to individuals seeking immediate medical attention. You will be responsible for conducting virtual consultations, diagnosing and treating a wide range of acute and minor medical conditions, and offering guidance to patients, all while adhering to established clinical protocols and standards of care.
Preference is for the NP to be local to Rochester, NY or surrounding areas.
STATUS: Full Time
LOCATION: Remote
DEPARTMENT: Virtual Urgent Care
SCHEDULE: Day/Evening; Every Other Weekend
ATTRIBUTES
  • At least 3 years of experience in urgent care or emergency medicine preferred; primary care and virtual medicine experience also considered
  • Compassionate, kind and patient focused
  • Excellent communication and interpersonal skills
  • Strong attention to detail and superior customer service

RESPONSIBILITIES
  • Diagnosis. Assess and diagnose acute illnesses and minor injuries; and implement treatment plan; monitor response for acute and chronic medical conditions; select and order appropriate diagnostic and health maintenance procedures
  • Treatment. Prescribe medication, provide health education and guidance regarding treatment; recommend community resources and refer patients to collaborating physician or specialist
  • Administrative Assistance. Perform administrative responsibilities such as updating patient charts, billing codes and completing required documents from outside agencies. Performs in-basket responsibilities such as reviewing test results, medication refills, returning patient calls and completing related clinical follow-up

EDUCATION:
MS: Nursing (Required)
LICENSES / CERTIFICATIONS:
NP - Nurse Practitioner Certification - New York State Education Department (NYSED)New York State Education Department (NYSED)New York State Education Department (NYSED), RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)New York State Education Department (NYSED)
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$100,000.00 - $150,000.00
CITY:
Rochester
POSTAL CODE:
14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

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