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Remote Utilization Review Rn Jobs in Edgewood, KY

Sedgwick

Field Case Manager - Vocational

Cincinnati, OH · On-site +1

... remote work environment that allows face to face interaction with injured workers and medical ... LICENSING RN licensure preferred; or graduate degree in health or human services field required ...

TriHealth

Supervisor Revenue Integrity

Cincinnati, OH · Remote

... RN, BSN) Required or * CPC - Certified Professional Coder Required Job Overview: The Supervisor of Revenue Integrity is responsible for overseeing charge auditing, charge entry, charge review, and ...

TriHealth

Supervisor Revenue Integrity

Cincinnati, OH · On-site +1

... RN, BSN) Required or * CPC - Certified Professional Coder Required Job Overview: The Supervisor of Revenue Integrity is responsible for overseeing charge auditing, charge entry, charge review, and ...

micro1 AI

Pharmacovigilance Expert

Cincinnati, OH · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Clinical Pharmacy Technicians

Cincinnati, OH · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

Varsity Tutors

NCLEX Tutor

Cincinnati, OH · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

Ledcor Group

Site Acquisition Specialist

Cincinnati, OH · On-site +1

Review and interpret purchase agreements and other legal documents * Build strong relationships ... This role will begin as a remote (work-from-home) position and will transition to a full-time, in ...

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Remote Utilization Review Rn information

See Edgewood, KY salary details

$21

$41

$68

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

As of Aug 22, 2026, the average hourly pay for remote utilization review rn in Edgewood, KY is $41.69, according to ZipRecruiter salary data. Most workers in this role earn between $32.93 and $47.88 per hour, depending on experience, location, and employer.

What is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Edgewood, KY?

For Remote Utilization Review Rn jobs in Edgewood, KY, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Edgewood, KY look for?

The top searched job categories for Remote Utilization Review Rn jobs in Edgewood, KY are:

What cities near Edgewood, KY are hiring for Remote Utilization Review Rn jobs?

Cities near Edgewood, KY with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Edgewood, KY as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $86,711 per year, or $41.7 per hour.

Coder II, Corporate Coding, Outpatient Ancillary Services, Full Time, First Shift

UC Health

Cincinnati, OH • Remote

$18 - $24/hr

Full-time

Posted 8 days ago

UC Health (Cincinnati) rating

6.9

Company rating: 6.9 out of 10

Based on 147 frontline employees who took The Breakroom Quiz

456th of 891 rated healthcare providers

Job description

Job Description Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Responsibilities Coding quality: Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG's.

Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation. Maintains a coding accuracy rating of at least 95% on records assigned. Queries physicians when necessary to ensure documentation supports the codes assigned.

Coding productivity: Performs coding on medical records in an efficient manner meeting productivity standards and assisting the department in meeting and maintaining its goals. Completes productivity data correctly and timely. Billing edits, coding corrections, DRG changes: Reviews, researches, and resolves claim edits for billing purposes.

Reviews records following feedback from payers, auditors and managers and makes corrections to coding, disposition and/or DRG assignment when indicated. Accountability: Reviews educational materials thoroughly and takes responsibility for applying this information when coding. Seeks to clarify information and educational material when necessary.

Listens actively. Maintains information and resources in an organized manner so that information can be referenced easily. Reviews emails timely and thoroughly and responds when indicated.

Manages the remote work setting effectively and comes on site when system, connectivity or other issues arise that would impact work performance. Qualifications Minimum Requirements: High school diploma or GED. Formal education in ICD-9-CM/CPT coding, medical terminology, anatomy, pathophysiology, and disease processes.

At least 1 year of acute care coding experience. Preferred Qualifications: Associate's degree in a healthcare-related field. Bachelor's degree in a healthcare-related field.

Certification in one of the following: Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Certified Coding Specialist (CCS) Certification Requirement: Candidates must hold one of the following credentials: RHIT, RHIA, or CCS. At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world.

Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is an EEO employer. Apply.

What UC Health (Cincinnati) employees say

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About UC Health

Sourced by ZipRecruiter

We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion.

Company size

10,000+ Employees

Headquarters location

Cincinnati, OH, US

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