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Remote Rn Insurance Jobs in Madison, WI (NOW HIRING)

WPS

Appeals Registered Nurse

Madison, WI · On-site +1

$30.50 - $40.25/hr

  • Medical

  • Dental

  • Retirement

  • PTO

Work Location We are open to remote work in the following approved states: Colorado, Florida ... Health insurance, dental insurance, and telehealth services start DAY 1 * Professional and ...

WPS Health Solutions

Appeals Registered Nurse

Madison, WI · On-site +1

  • Medical

  • Dental

  • Retirement

  • PTO

Work Location We are open to remote work in the following approved states: Colorado, Florida ... Health insurance, dental insurance, and telehealth services start DAY 1 * Professional and ...

Quartz

RN Complex Care Specialist

Madison, WI · Remote

$72K - $90K/yr

As an RN Complex Care Specialist , you will lead the management and coordination of care for ... Proficiency using Epic systems and remote monitoring programs. * Cultural competence and ...

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · Remote

$34.50 - $44/hr

  • Medical

  • Life

  • Retirement

  • PTO

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ...

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · On-site +1

$34.50 - $44/hr

  • Medical

  • Life

  • Retirement

  • PTO

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ...

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · On-site +1

$34.50 - $44/hr

  • Medical

  • Life

  • Retirement

  • PTO

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ...

Corvel

Care Advocate Nurse

Madison, WI · Remote

$61K - $98K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ... Current unencumbered RN Licensure in state of residency and practicing state(s) must be maintained ...

MDS Solutions

Remote Sr. Director of Operations

Madison, WI · On-site +1

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Current and unrestricted RN license in state(s) assigned • Required: RAC-CT certification upon ... Valid driver license and car insurance as required by state law. • Required: Other as required by ...

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Showing results 1-20

All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in Madison, WI

Remote Rn Insurance information

See Madison, WI salary details

$7

$42

$72

How much do remote rn insurance jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for remote rn insurance in Madison, WI is $42.50, according to ZipRecruiter salary data. Most workers in this role earn between $31.68 and $50.29 per hour, depending on experience, location, and employer.

What is a Remote RN Insurance nurse?

A Remote RN Insurance nurse is a registered nurse who works with insurance companies to review medical claims, assess patient care needs, and help determine the medical necessity of treatments—often from a home office. Their responsibilities may include case management, utilization review, and providing telephonic support to patients or healthcare providers. This role requires strong clinical experience, excellent communication skills, and the ability to analyze medical records and insurance policies. Working remotely, these nurses help ensure patients receive appropriate care while also managing healthcare costs for insurance providers.

What are the key skills and qualifications needed to thrive as a Remote RN Insurance nurse?

To thrive as a Remote RN Insurance Nurse, you need an active RN license, a strong grasp of clinical practice, and experience in case management or utilization review. Familiarity with claims processing systems, telehealth platforms, and knowledge of medical coding (ICD-10, CPT) are typically required, along with certifications like CCM or URAC being advantageous. Exceptional communication, critical thinking, and time management skills help you collaborate with patients, providers, and insurance teams effectively. These competencies ensure accurate assessments, efficient case handling, and high-quality service in a remote, compliance-driven environment.

What are some common challenges faced by Remote RN Insurance professionals, and how can they be managed effectively?

Remote RN Insurance professionals often encounter challenges such as managing a high volume of case reviews, maintaining clear communication with both patients and insurance teams, and staying updated with changing insurance policies and regulations. To manage these challenges, it’s important to develop strong organizational skills, utilize effective digital communication tools, and participate in ongoing training. Engaging with a supportive team and seeking mentorship within the organization can also help in adapting to the remote environment and ensuring quality outcomes.

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

AspectRemote Rn InsuranceRemote Rn Case Manager
CertificationsRN license, insurance knowledgeRN license, case management certification
Work EnvironmentInsurance companies, telehealthHealthcare facilities, telehealth
Employer & IndustryInsurance providers, telehealth companiesHospitals, insurance companies, healthcare agencies

Remote Rn Insurance focuses on assessing insurance claims and policy coverage, while Remote Rn Case Managers coordinate patient care plans. Both roles require RN licensure and involve telehealth work, but their primary responsibilities and employer settings differ.

What are popular job titles related to Remote Rn Insurance jobs in Madison, WI?

For Remote Rn Insurance jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Remote Rn Insurance jobs in Madison, WI look for?

The top searched job categories for Remote Rn Insurance jobs in Madison, WI are:

What cities near Madison, WI are hiring for Remote Rn Insurance jobs?

Cities near Madison, WI with the most Remote Rn Insurance job openings:

Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in Madison, WI as of August 2026, with employment types broken down into 67% Full Time, and 33% Contract. Highlights an 100% Remote job distribution, with an average salary of $88,407 per year, or $42.5 per hour.

Appeals Registered Nurse

WPS

Madison, WI • On-site, Remote

$30.50 - $40.25/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 9 days ago

Job description

Role SnapshotThe Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies. The Appeals RN works in collaboration with the Appeals Examiners/Reps to ensure redeterminations are medically reviewed as needed and completed timely.
Salary Range
66-68k
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.
Work LocationWe are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you are interested in the following activities:
  • Review and assess first-level appeal cases for denied services, ensuring all relevant medical documentation, coding, and clinical information are provided to support the appeal.
  • Conduct comprehensive medical record reviews to determine the clinical necessity of services and make recommendations for resolution based on clinical guidelines, policy, and the medical necessity of care.
  • Prepare and submit written appeal letters, including comprehensive rationales and supporting clinical evidence.
  • Ensure timely follow-up on all appeals and ensure proper resolution is reached in accordance with company policies and external regulations.
  • Maintain awareness of healthcare laws, regulations, and policies relevant to the appeals process, ensuring all actions comply with regulatory and contractual requirements.
  • Work with and provide directions to Redetermination Representatives to ensure all redeterminations, which require a clinical decision, are responded to within CMS quality and timelines standards.

Minimum Qualifications
  • Associate's (ASN) or Bachelor's Degree in Nursing (BSN).
  • Active RN license, applicable to state of practice in good standing.
  • One (1) or more years of clinical experience in a healthcare setting (hospital/bedside, case management, MDS/Skilled Nursing, etc.).
  • Excellent written and verbal communication skills, with the ability to communicate complex medical information clearly and concisely.
  • Strong attention to detail and organizational skills to manage multiple cases simultaneously.
  • Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization Review).
  • Solid computer skills with experience working in multiple on-line systems including MS Outlook, Teams, OneNote, Word, and Excel.

Preferred Qualifications
  • Experience working for a Medicare Administrative Contractor (MAC) preferred.
  • One (1) or more years of experience working in Medical Management (e.g., MDS role), Medical Review, Utilization Management/Review, or Appeals preferred.
  • Basic Medicare knowledge and/or experience preferred.

Remote Work Requirements
  • Wired (ethernet cable) internet connection from your router to your computer.
  • High speed cable or fiber
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
  • Please review Remote Worker FAQs for additional information.

Benefits
  • Remote and hybrid work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
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Medicare (GHA)
This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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