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Remote Nurse Reviewer Jobs in Springfield, IL (NOW HIRING)

DataAnnotation

RN

Springfield, IL · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

Datavant

Inpatient Audit Specialist FT

Springfield, IL · Remote

This role is fully remote with a flexible schedule, allowing you to help shape the future of health ... Review non-CC/MCC records to assess proper coding or identify the need for additional documentation.

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Remote Nurse Reviewer information

See Springfield, IL salary details

$28

$36

$42

How much do remote nurse reviewer jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote nurse reviewer in Springfield, IL is $36.71, according to ZipRecruiter salary data. Most workers in this role earn between $33.85 and $40.96 per hour, depending on experience, location, and employer.

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 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.

More about Remote Nurse Reviewer jobs
What are popular job titles related to Remote Nurse Reviewer jobs in Springfield, IL? For Remote Nurse Reviewer jobs in Springfield, IL, the most frequently searched job titles are:
What job categories do people searching Remote Nurse Reviewer jobs in Springfield, IL look for? The top searched job categories for Remote Nurse Reviewer jobs in Springfield, IL are:
What cities near Springfield, IL are hiring for Remote Nurse Reviewer jobs? Cities near Springfield, IL with the most Remote Nurse Reviewer job openings:
Remote Nurse Reviewer jobs near you
Infographic showing various Remote Nurse Reviewer job openings in Springfield, IL as of May 2026, with employment types broken down into 13% As Needed, 27% Full Time, 49% Part Time, and 11% Contract. Highlights an 66% Physical, and 34% Remote job distribution, with an average salary of $76,349 per year, or $36.7 per hour.

Telephonic Nurse Care Associate

Advanced Monitored Caregiving Inc.

Springfield, IL • Remote

Full-time

Posted 21 days ago

Job description

At AMC Health, we are transforming healthcare through advanced remote patient monitoring and virtual care solutions that help patients manage chronic conditions safely at home. Our care teams play a critical role in improving outcomes, enhancing patient engagement, and reducing avoidable hospitalizations.

We are seeking a Telephonic Nurse Care Associate (LPN/LVN) who is passionate about patient engagement, chronic care support, and using technology to improve healthcare delivery.

What You’ll Do

  • Conduct telephonic clinical outreach to patients enrolled in Remote Patient Monitoring (RPM) and chronic care programs.
  • Review biometric alerts and identify out-of-range readings; escalate clinical concerns according to protocols.
  • Provide patient education and coaching to support adherence to care plans and lifestyle recommendations.
  • Accurately document patient encounters in EMR/RPM systems in compliance with clinical and regulatory standards.
  • Collaborate with clinical management, RN Care Managers, providers, and interdisciplinary care teams to coordinate patient care.
  • Support patient engagement initiatives designed to improve monitoring compliance and clinical outcomes.

What You Bring

  • Active LPN/LVN license in good standing.
  • 5+ years of clinical experience, including 3+ years in care coordination, telehealth, home care, or chronic disease management.
  • Experience supporting patients with conditions such as CHF, COPD, diabetes, or hypertension preferred.
  • Strong telephonic communication, patient education, and motivational interviewing skills.
  • Experience using EMR/EHR systems and comfort working in a technology-enabled care environment.
  • Ability to work independently in a structured remote clinical workflow.

Why AMC Health

  • Fully remote clinical role supporting patients nationwide
  • Opportunity to work at the forefront of virtual care innovation
  • Collaborative interdisciplinary care teams
  • Meaningful work improving patient outcomes every day
  • Growth opportunities within expanding virtual care programs

Work Environment Requirements

  • Private, secure, distraction-free home workspace
  • Reliable high-speed internet connectivity
  • Ability to work schedules aligned with assigned patient populations or client time zones

Apply