Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health ... Experience managing remote and/or offshore teams (Philippines experience preferred). * Strong ...
Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health ... Experience managing remote and/or offshore teams (Philippines experience preferred). * Strong ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Knowledge of insurance programs program, particularly the coverage and payment rules. * Ability to ... remote setting. Required and Preferred Qualifications: * Active unrestricted RN license in good ...
Medical Review Nurse - CMS RAC (Government audits)
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Knowledge of insurance programs program, particularly the coverage and payment rules. * Ability to ... remote setting. Required and Preferred Qualifications: * Active unrestricted RN license in good ...
Utilization Review Nurse (U)
Miami, FL · On-site +1
... RN (U) coordinates the overall interdisciplinary plan of care for patients, from admission to discharge. Monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers.
Utilization Review Nurse (U)
Miami, FL · On-site +1
... RN (U) coordinates the overall interdisciplinary plan of care for patients, from admission to discharge. Monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers.
LPN Care Coordinator - CCM/RPM- Spanish Speaking Required
Miami, FL · On-site +1
$26 - $27/hr
... Remote) (Spanish Speaking Required) Overview : The Care Coordinator is responsible for developing and providing care coordination services directly to Alopex clients' patients. Reports To : RN ...
LPN Care Coordinator - CCM/RPM- Spanish Speaking Required
Miami, FL · On-site +1
$26 - $27/hr
... Remote) (Spanish Speaking Required) Overview : The Care Coordinator is responsible for developing and providing care coordination services directly to Alopex clients' patients. Reports To : RN ...
LPN Care Coordinator - CCM/RPM- Spanish Speaking Required
Miami, FL · Remote
$26 - $27/hr
... Remote) (Spanish Speaking Required) Overview : The Care Coordinator is responsible for developing and providing care coordination services directly to Alopex clients' patients. Reports To : RN ...
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LPN Care Coordinator - CCM/RPM- Spanish Speaking Required
Miami, FL · Remote
$26 - $27/hr
... Remote) (Spanish Speaking Required) Overview : The Care Coordinator is responsible for developing and providing care coordination services directly to Alopex clients' patients. Reports To : RN ...
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Psych Nurse Practitioner (PMHNP, Psych APRN)
Miami, FL · Remote
$250K - $500K/yr
Maintain accurate medical documentation in compliance with HIPAA & insurance regulations * Offer ... Remote Compensation Range: $250K - $500K
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Psych Nurse Practitioner (PMHNP, Psych APRN)
Miami, FL · Remote
$250K - $500K/yr
Maintain accurate medical documentation in compliance with HIPAA & insurance regulations * Offer ... Remote Compensation Range: $250K - $500K
Apply Early
RN - AI Trainer
Miami Gardens, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Miami Gardens, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Davie, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Davie, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Coral Springs, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Coral Springs, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Boca Raton, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Boca Raton, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Miramar, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Miramar, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Miami, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Miami, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Hollywood, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Hollywood, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Sunrise, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Sunrise, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Pompano Beach, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
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RN - AI Trainer
Pompano Beach, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Pembroke Pines, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Pembroke Pines, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Plantation, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Plantation, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Fort Lauderdale, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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RN - AI Trainer
Fort Lauderdale, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
RN - AI Trainer
Hialeah, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
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RN - AI Trainer
Hialeah, FL · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Apply Early
Remote Psychiatric Nurse Practitioner (PMHNP) - Florida
Miami, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... Employer-paid health, dental, and vision insurance (up to 100% of premiums) * 401(k) with employer ...
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Remote Psychiatric Nurse Practitioner (PMHNP) - Florida
Miami, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... Employer-paid health, dental, and vision insurance (up to 100% of premiums) * 401(k) with employer ...
Apply Early
Remote Rn Insurance information
See Miramar, FL salary details
$6.91 - $12.35
0% of jobs
$12.35 - $17.80
0% of jobs
$17.80 - $23.25
4% of jobs
$23.25 - $28.70
18% of jobs
$29.41 is the 25th percentile. Wages below this are outliers.
$28.70 - $34.15
20% of jobs
The median wage is $36.39 / hr.
$34.15 - $39.59
18% of jobs
$44.50 is the 75th percentile. Wages above this are outliers.
$39.59 - $45.04
16% of jobs
$45.04 - $50.49
10% of jobs
$50.49 - $55.94
6% of jobs
$55.94 - $61.39
4% of jobs
$61.39 - $66.83
3% of jobs
$6
$39
$66
How much do remote rn insurance jobs pay per hour?
What are the key skills and qualifications needed to thrive as a Remote RN Insurance Nurse, and why are they important?
What is the difference between Remote Rn Insurance vs Remote Rn Case Manager?
| Aspect | Remote Rn Insurance | Remote Rn Case Manager |
|---|---|---|
| Certifications | RN license, insurance knowledge | RN license, case management certification |
| Work Environment | Insurance companies, telehealth | Healthcare facilities, telehealth |
| Employer & Industry | Insurance providers, telehealth companies | Hospitals, 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 is a Remote RN Insurance nurse?
What are some common challenges faced by Remote RN Insurance professionals, and how can they be managed effectively?

Full-time
Posted 22 days ago
Job description
Job Summary:
We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers. This role is responsible for overseeing day-to-day activities of clinical appeal specialists, managing appeal strategy execution, ensuring quality and compliance, and meeting client-specific performance goals.
The ideal candidate brings a strong background in clinical review, medical necessity denials, payer appeal processes, and team leadership—ideally across both U.S. and offshore teams (e.g., Philippines). This position is critical to ensuring timely and effective resolution of denied claims, supporting revenue recovery efforts, and maintaining payer and regulatory compliance.
Key Responsibilities:
- Manage the full-cycle clinical appeals process across multiple payer types, with a focus on government (e.g., Medicare, Medicaid) and commercial payers.
- Lead and support a team of nurses, clinical reviewers, and appeal specialists—including potential offshore (Philippines-based) staff.
- Monitor appeal workloads, productivity, and turnaround times to ensure all appeal deadlines and client service level agreements (SLAs) are met.
- Review and approve complex or high-value clinical appeal cases, ensuring clinical accuracy and compliance with payer guidelines.
- Maintain up-to-date knowledge of medical necessity criteria, payer policies, NCDs/LCDs, and applicable CMS regulations.
- Train new and existing team members on clinical guidelines, appeal writing standards, and regulatory requirements.
- Work cross-functionally with audit, legal, compliance, and operations teams to align on strategy and escalate trends or systemic payer issues.
- Identify and implement process improvements to increase efficiency, reduce denials, and improve overturn rates.
- Support the creation and refinement of appeal templates, clinical arguments, and documentation standards.
- Generate and deliver performance and quality reports to leadership, identifying risks and opportunities for improvement.
Qualifications:
- Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health Administration, or related field preferred.
- 5+ years of experience in clinical appeals, utilization review, or medical necessity denials.
- 2+ years in a leadership or supervisory role, preferably within a revenue cycle or payer appeals setting.
- In-depth understanding of payer denial processes, especially Medicare Advantage, Medicaid Managed Care, and commercial plans.
- Experience managing remote and/or offshore teams (Philippines experience preferred).
- Strong working knowledge of ICD-10, CPT, and HCPCS coding as they relate to clinical justifications.
- Excellent writing skills and the ability to clearly communicate complex clinical reasoning.
- Familiarity with appeal submission portals, EHRs, and workflow platforms.
- Knowledge of HIPAA, CMS, and NCQA standards.
About Health Business Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Cooper City, FL, US
Year founded
2002