ZipRecruiter

Log In

2

Remote Rn Case Review Jobs in Reading, PA (NOW HIRING)

Varsity Tutors

NCLEX-RN Tutor

Reading, PA · Remote

$18 - $40/hr

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

Sodexo

Registered Dietitian

Wernersville, PA · On-site +1

$29 - $39/hr

Potential for Some Remote Hours! Free lunch and Free parking! What You'll Do * See patients ... Represent the Food & Nutrition Department as the primary liaison with the medical and nursing staff

Varsity Tutors

NCLEX Tutor

Reading, PA · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario ... as registered nurses or licensed practical nurses. * Effective Teaching Methods: Ability to ...

Varsity Tutors

NCLEX-PN Tutor

Reading, PA · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Wider Circle

Care Advocate - Care Delivery

Reading, PA · Remote

... reviewed literature. Today, Wider Circle offers its unique neighborhood care programs to tens of ... Our mission is to integrate Case Management, Care Navigation, and Benefits Enrollment into a single ...

Varsity Tutors

Series 9 Tutor

Reading, PA · Remote

$18 - $40/hr

... preparing registered representatives for supervisory qualification. * Strategic Test-Taking ... Adapts instruction using practice examinations, regulatory case studies, and compliance scenario ...

All JobsRn Case Review JobsRemote Rn Case Review JobsRemote Rn Case Review Jobs in Reading, PA

Remote Rn Case Review information

See Reading, PA salary details

$18

$45

$76

How much do remote rn case review jobs pay per hour?

As of Jul 9, 2026, the average hourly pay for remote rn case review in Reading, PA is $45.65, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $55.19 per hour, depending on experience, location, and employer.

What is the difference between Remote Rn Case Review vs Remote Rn Utilization Review?

AspectRemote Rn Case ReviewRemote Rn Utilization Review
CredentialsRegistered Nurse (RN), licensure, case review certificationsRegistered Nurse (RN), licensure, utilization review certifications
Work EnvironmentRemote, healthcare settings, insurance companiesRemote, healthcare settings, insurance companies
Employer & IndustryHospitals, insurance firms, healthcare providersInsurance companies, healthcare management organizations

Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

What are popular job titles related to Remote Rn Case Review jobs in Reading, PA? For Remote Rn Case Review jobs in Reading, PA, the most frequently searched job titles are:
What job categories do people searching Remote Rn Case Review jobs in Reading, PA look for? The top searched job categories for Remote Rn Case Review jobs in Reading, PA are:
What cities near Reading, PA are hiring for Remote Rn Case Review jobs? Cities near Reading, PA with the most Remote Rn Case Review job openings:
Remote Rn Case Review jobs near you
Infographic showing various Remote Rn Case Review job openings in Reading, PA as of July 2026, with employment types broken down into 57% Full Time, and 43% Part Time. Highlights an 100% Remote job distribution, with an average salary of $94,948 per year, or $45.6 per hour.

Nurse Reviewer - Reading, PA

Healthcare Quality Strategies, Inc.

Reading, PA • Remote

$40/hr

Part-time

Medical, Dental, Vision, Life, Retirement

Re-posted 26 days ago

Job description

Nurse Reviewer
PT (20-30 hours week) – Remote Work Environment
Non-Exempt: $40.00 hour
Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy reviews for Medicaid claims. This involves meticulous examination of claims and medical records to ensure compliance with established guidelines and regulations. The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely.
Essential Duties and Responsibilities:
  • Conduct comprehensive medical record reviews to assess medical necessity and compliance with established standards of care and applicable policies
  • Manage end-to-end case screening processes, ensuring all activities are completed within established deadlines
  • Document evidence-based criteria applicable to specific contract requirements
  • Record and report screening results, including relevant referral questions, into a centralized database
  • Evaluate medical claims against industry standards, utilizing research of relevant ICD-10, CPT, and HCPCS codes to determine medical necessity
  • Maintain expert knowledge of evolving multi-state Medicaid policies and vendor expectations
  • Participate in ongoing training and consistently meet or exceed productivity and quality assurance standards
Knowledge, Experience, Skills and Education:
  • Medical terminology, ICD-10, CPT and HCPCS
  • Clinical criteria (InterQual and MCG)
  • Utilization/Medical record review and chart abstraction
  • Current standards of medical practice
  • Comply with HIPAA/HITECH laws and regulations
Experience in:
  • At least three- five years performing medical record review and/or abstraction (Utilization Review experience preferred)
  • Experience performing medical record review, audit for federal or state contracts
  • Knowledge and experience of Medicare and Medicaid policy
  • Proficiency with Microsoft Office (Word, Excel, and Outlook)
  • Proficiency with Adobe PDF files and features
  • Generating accurate, timely, and understandable correspondence
  • Current experience (within the last 3 years) in the application of clinical screening criteria (InterQual and MCG)
Skills Requirements include:
  • Professional interpersonal skills; ability to interact with providers, physicians and peers
  • Solid analytical, assessment and documentation skills
  • Effective written and verbal communication, both internally and externally
  • Strong attention to detail
  • Strong attention to deadlines
  • Organizational skills including effective time management, priority setting and process improvement
  • Ability to work independently and as a member of a team
  • Adapt to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations
Educational Background:
  • BSN with active RN licensure in good standing
Physical Demands:
Remote Work, Prolonged Sitting, Screen Exposure
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This position qualifies for the following Company benefits: Medical/Dental/Vision, FSA and HSA, group life/AD amp;D, voluntary life/AD amp;D, 401k
For immediate consideration, please apply via the HQSI Careers Page at: www.hqsi.org gt; Careers gt; Current Employment Opportunities
EOE: Minorities/Females/Disabled/Veterans
Healthcare Quality Strategies, Inc. is Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug Free Workplace
Healthcare Quality Strategies, Inc. is an E-Verify Employer

Apply