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Remote Utilization Review Rn Jobs in Mobile, AL (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Mobile, AL · On-site +1

$48.75 - $59.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

DataAnnotation

Registered Nurse - AI Trainer

Mobile, AL · 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 ...

DataAnnotation

RN - AI Trainer

Mobile, AL · 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 ...

ZOLL Medical

Patient Service Representative

Daphne, AL · Remote

$15.25 - $19.25/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

ZOLL LifeVest

Patient Service Representative

Foley, AL · Remote

$15 - $19/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

ZOLL Medical

Patient Service Representative

Foley, AL · Remote

$15 - $19/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

Outokumpu

Legal Counsel - USA & Canada

Calvert, AL · On-site +1

If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...

All JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Mobile, AL

Remote Utilization Review Rn information

See Mobile, AL salary details

$21

$41

$68

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

As of Jun 19, 2026, the average hourly pay for remote utilization review rn in Mobile, AL is $41.96, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.17 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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 Mobile, AL? For Remote Utilization Review Rn jobs in Mobile, AL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Mobile, AL look for? The top searched job categories for Remote Utilization Review Rn jobs in Mobile, AL are:
What cities near Mobile, AL are hiring for Remote Utilization Review Rn jobs? Cities near Mobile, AL with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

RN, DRG Coder / Clinical Auditor

Pivotal Placement Services

Mobile, AL • Remote

$95K - $105K/yr

Full-time

Posted 10 days ago

Job description

RN, DRG Coder / Clinical Auditor
Must be a Registered Nurse with experience

📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding

About the Role

We’re seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical records and documentation. This role ensures accurate coding and clinical support for DRG assignments, helping improve billing accuracy, reimbursement, and compliance. You’ll work independently to review records, validate coding, and communicate findings clearly and professionally.

Key Responsibilities

  • Chart Review & Validation
    Review medical records to validate DRG assignments and ensure clinical documentation supports coding decisions.

  • Physician Documentation Review
    Confirm that physician notes and clinical indicators support assigned DRGs.

  • Audit & Compliance
    Conduct audits to verify coding accuracy, enhance reimbursement, and identify cost-saving opportunities.

  • Coding Expertise
    Apply ICD-10-CM and PCS coding guidelines, payer rules, and regulatory standards (Medicare, Medicaid, CMS).

  • Communication & Reporting
    Clearly document findings and communicate results in a professional and concise manner.

  • Other Duties
    Support additional documentation and coding-related tasks as assigned.

Qualifications
  • Licensure: RN
  • Experience:
    • Minimum 1 year of recent DRG auditing experience in a hospital or health plan setting.
    • Inpatient ICD-10 coding experience required.
    • CDI candidates are encouraged to apply.
  • Certifications:
    • National coding certification through AHIMA (preferred) or AAPC.
    • CCS or CIC strongly preferred.
  • Technical Skills:
    • Proficient in MS and APR DRG methodology.
    • Familiarity with Coding Clinic citations and Official Coding Guidelines.
    • Strong understanding of Medicare/CMS documentation requirements.
  • Soft Skills:
    • Exceptional attention to detail.
    • Strong problem-solving and critical thinking abilities.
    • Effective verbal and written communication.
    • Ability to work independently in a fast-paced, production-driven environment.
  • Tools:
    • Proficient in Microsoft Office Suite.
Compensation

💵 Pay Range: $90,000 – $104,841
Salary is based on location, experience, qualifications, and internal equity. Final compensation may vary depending on assessment during the interview process.

Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.