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Remote Utilization Review Rn Jobs in Jacksonville, FL

Varsity Tutors

NCLEX-PN Tutor

Jacksonville, FL · 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 ...

Allara

Telehealth Nurse Practitioner | W2 FT

Jacksonville, FL · Remote

$120K - $130K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Fully remote within the U.S. Your Impact * Conduct thorough patient assessments and develop ... All active and pending licenses held at the time of application are collected and reviewed during ...

ARC Group

Medical Research Consultant

Jacksonville, FL · Remote

MEDICAL RESEARCH CONSULTANT REMOTE ARC Group has an immediate opportunity for a Medical Research ... Accountabilities include identification, receipt, tracking, review, analysis, and recommendation ...

Paul Davis Restoration, Inc.

Estimate Auditor

Jacksonville, FL · Remote

$60K - $70K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

FLEXIBLE POSITION - REMOTE OR HYBRID ROLE REPORTS TO: Vice President, Claims Force SALARY RANGE ... Estimate audits include full desk reviews of all documentation in the claims platform, the estimate ...

micro1 AI

Pharmacovigilance Expert

Jacksonville, FL · 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

Jacksonville, FL · 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

Jacksonville, FL · 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 ...

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Remote Utilization Review Rn information

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$38

$62

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

As of Aug 16, 2026, the average hourly pay for remote utilization review rn in Jacksonville, FL is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 per hour, depending on experience, location, and employer.

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 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 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 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 are popular job titles related to Remote Utilization Review Rn jobs in Jacksonville, FL?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Jacksonville, FL are:

What cities near Jacksonville, FL are hiring for Remote Utilization Review Rn jobs?

Cities near Jacksonville, FL 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 Jacksonville, FL as of August 2026, with employment types broken down into 5% As Needed, 75% Full Time, 10% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $79,822 per year, or $38.4 per hour.

PhysicianBillingComplianceAnly | Downtown/Remote | Days

UF Health

Jacksonville, FL • On-site, Remote

Full-time

Posted 19 days ago

Job description

Overview
Job Duties
Under limited supervision, the Physician Billing Compliance Analyst ("Analyst") will perform physician coding/documentation audits for providers of the University of Florida College of Medicine - Jacksonville ("COM-Jax") and the University of Florida Jacksonville Physicians Group ("UFJPI"). Analyst will also perform abbreviated reviews on newly hired providers' documentation outside of the regular compliance audit cycle. Audit focus will be on physician/advanced practice professional coding and chart documentation to include review of E&M, CPT, ICD-10-CM, HCPCS Level II, teaching physician guidelines and carrier specific policies. The Analyst will utilize medical management systems as well as auditing software applications to perform reviews. The Analyst will prepare and present accurate reports of audit findings to appropriate personnel. The Analyst will coordinate with various COM-Jax and UFJPI representatives to process any resulting refunds and address educational needs from the audit findings.
Responsibilities
Essential Functions
• Within designated timeframes and by utilizing medical management systems, audit chart documentation and professional billing for compliance with E&M, CPT procedure coding, ICD-10-CM diagnosis coding, teaching physician guidelines, payer specific polices and regulatory requirements.
• Perform analysis of audit findings and summarize for placement in the Physician Billing Compliance Services ("PBC") central database.
• Participate in opening and closing audit conferences with representatives of the COM-Jax and UFJPI.
• Identify remedial training needs through audit process and if necessary, conduct remedial training with providers and/or UFJPI billing staff.
• Assist in the development of policies and procedures to complete work in accordance with the COM - Jax Billing Compliance Plan.
• Problem solve issues identified during the audit process.
• Assist with creation and performance of audits through the utilization of various auditing software programs.
• Assist Manager and Director of PBC with research and analysis for special projects and other duties as assigned.
Qualifications
Experience Requirements
2 years Medical billing required
4 years Medical coding (procedural and diagnosis) for multi-specialty providers required
3 years Medicare, Medicaid, and Tricare payment and reimbursement rules required
3 years Medical record chart auditing for professional billing required
1 year Medical management information systems (EPIC preferred) required
1 year Auditing software applications (e.g. MDaudit, Compliance Risk Analyzer) preferred
Education Requirements
High School Diploma or GED required
Associates Business or health care industry related field preferred
Certification/Licensure/Training
Certified Coding Specialist required or at time of hire
Certified Coding Specialist - Physician Based(CCS-P) - AHIMA required or at time of hire
Certified Professional Coder (CPC) required or at time of hire
Certified Professional Medical Auditor (CPMA) required within 6 months
UFJPI is an Equal Opportunity Employer and Drug Free Workplace

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