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Remote Rn Insurance Assessment Jobs (NOW HIRING)

CVS Health

Case Manager Registered Nurse

Homer, AK · Remote

$60K - $129K/yr

Remote RN Case Manager (Nationwide | Monday-Friday, No Weekends) Join a mission-driven team helping ... Assess, plan, and coordinate care to support members' overall wellness * Use clinical judgment and ...

TEEMA Group

REMOTE RN - Quality Review

Phoenix, AZ · Remote

$42 - $43.50/hr

Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) * ... Remote or onsite depending on business needs * Must have a secure home office setup if remote

KYYBA

Remote RN Case Manager [MI RNs only]

Detroit, MI · Remote

$35 - $39/hr

Job Title: RN Case Manager Location: 100% Remote Duration: 12+ months License Required: Active ... Using telephonic and digital communication, the RN leads assessment, care planning, implementation ...

Phaxis

AIMS- REMOTE RN CARE MANAGER

NY · On-site +1

$61 - $63/hr

This role supports patients across the continuum of care following initial assessments through ... Current NYS RN license * Experience in case management, care coordination, or similar clinical ...

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Remote Rn Insurance Assessment information

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$72

How much do remote rn insurance assessment jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for remote rn insurance assessment in the United States is $38.99, according to ZipRecruiter salary data. Most workers in this role earn between $29.81 and $43.27 per hour, depending on experience, location, and employer.

What are some common challenges faced by Remote RN Insurance Assessment nurses, and how can they overcome them?

Remote RN Insurance Assessment nurses often encounter challenges such as managing a high volume of assessments, navigating various electronic health record systems, and ensuring thorough documentation while working independently. Effective time management, strong organizational skills, and ongoing communication with team members and supervisors are essential for success. Utilizing available training resources and participating in regular team meetings can also help nurses stay updated on best practices and maintain a collaborative work environment, even while working remotely.

What are Remote RN Insurance Assessment jobs?

Remote RN Insurance Assessment jobs involve registered nurses working from home to assess patients' health status for insurance companies. These nurses review medical records, conduct telephonic or virtual health assessments, and document findings to help insurance companies make decisions on coverage, claims, or wellness programs. The role requires strong clinical knowledge, attention to detail, and excellent communication skills. It offers flexibility and the opportunity to use nursing expertise outside of traditional clinical settings.

What is the difference between Remote Rn Insurance Assessment vs Remote Rn Case Manager?

AspectRemote Rn Insurance AssessmentRemote Rn Case Manager
CredentialsRegistered Nurse (RN) license, insurance assessment certificationsRegistered Nurse (RN) license, case management certifications
Work EnvironmentRemote, primarily conducting assessments via phone or onlineRemote, coordinating patient care and services
Employer & IndustryInsurance companies, third-party administratorsHealthcare providers, insurance companies, managed care organizations

While both roles require an RN license and involve remote work, Remote Rn Insurance Assessment focuses on evaluating insurance claims and determining coverage eligibility. In contrast, Remote Rn Case Managers coordinate ongoing patient care, manage treatment plans, and liaise with healthcare providers. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

What are the key skills and qualifications needed to thrive as a Remote RN Insurance Assessment Nurse, and why are they important?

To excel as a Remote RN Insurance Assessment Nurse, you need a current RN license, strong clinical assessment skills, and a thorough understanding of medical terminology and insurance protocols. Proficiency in telehealth platforms, electronic medical records (EMR), and insurance assessment tools such as MCG or InterQual is typically required. Exceptional communication, attention to detail, and the ability to work independently are crucial soft skills for this role. These competencies ensure accurate patient evaluations, effective remote collaboration, and compliance with insurance guidelines, ultimately leading to high-quality service and informed decision-making.
What cities are hiring for Remote Rn Insurance Assessment jobs? Cities with the most Remote Rn Insurance Assessment job openings:
What are the most commonly searched types of Rn Insurance Assessment jobs? The most popular types of Rn Insurance Assessment jobs are:
What states have the most Remote Rn Insurance Assessment jobs? States with the most job openings for Remote Rn Insurance Assessment jobs include:
Remote Rn Insurance Assessment jobs near you
Remote RN - Medical Claims Reviewer

Remote RN - Medical Claims Reviewer

Broadway Ventures

OR • Remote

Other

Posted 2 days ago

Job description

Job Type: Full-time (40 hours/week)
Schedule: Monday-Friday, 8:00 AM - 5:00 PM

Max Salary: W-2 ($65,000/$31.25)

Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience plus at least two years in one of the following:
    • Home Health
    • Utilization/Medical Review
    • Quality Assurance
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
Preferred Qualifications
  • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
  • Proficiency in using multiple screens and software programs simultaneously.

If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!

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