Lead RN Reviewer
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in ...
Albany, NY · On-site
$50/hr
Greenlife Healthcare Staffing is seeking an experienced Maternal Nurse Reviewer to conduct clinical ... Must be qualified and actively credentialed|registered in New York State (e.g., Registered ...
Albany, NY · On-site
$50/hr
Greenlife Healthcare Staffing is seeking an experienced Maternal Nurse Reviewer to conduct clinical ... Must be qualified and actively credentialed|registered in New York State (e.g., Registered ...
VA · On-site
$82K - $95K/yr
The Nurse Reviewer performs complex medical record reviews of Medicare Part A/B and DMEPOS claims ... Nurse (RN); active compact multistate RN license acceptable * License recognized in the ...
Reading, PA · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Reading, PA · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Wilkes Barre, PA · On-site
$67K - $75K/yr
Must possess a current, unrestricted State license as a Registered Nurse (RN),as required by contract(s). * 1+ years clinical experience required; coding, utilization, and/or medical chart review ...
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Wilkes Barre, PA · On-site
$67K - $75K/yr
Must possess a current, unrestricted State license as a Registered Nurse (RN),as required by contract(s). * 1+ years clinical experience required; coding, utilization, and/or medical chart review ...
Sarasota, FL · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Sarasota, FL · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Orlando, FL · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Orlando, FL · Remote
$40/hr
The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: * Conduct comprehensive medical record ...
Join a dedicated healthcare team in the Midwest region as an Advanced Cardiac Cath Lab RN Reviewer focused on quality assurance. This role involves meticulous collection and submission of clinical ...
Join a dedicated healthcare team in the Midwest region as an Advanced Cardiac Cath Lab RN Reviewer focused on quality assurance. This role involves meticulous collection and submission of clinical ...
Plano, TX · On-site
$59K - $75K/yr
Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Plano, TX · On-site
$59K - $75K/yr
Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Reston, VA · On-site
$66K - $106K/yr
At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...
Reston, VA · On-site
$66K - $106K/yr
At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...
$66K - $106K/yr
At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...
$66K - $106K/yr
At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...
Surgical Case Nurse Reviewer LOCATION: Nellis AFB, Nevada HOURS: Monday through Friday - 9-hour ... S. licensed Registered Nurse. * License cannot be under investigation nor have any adverse action ...
Surgical Case Nurse Reviewer LOCATION: Nellis AFB, Nevada HOURS: Monday through Friday - 9-hour ... S. licensed Registered Nurse. * License cannot be under investigation nor have any adverse action ...
The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a ...
The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a ...
Saint Petersburg, FL · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Saint Petersburg, FL · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Currently licensed in Hawaii as an RN or LPN (if applicable upon hire, proof of licensure to be provided by employee or confirmed by Human Resources)
Currently licensed in Hawaii as an RN or LPN (if applicable upon hire, proof of licensure to be provided by employee or confirmed by Human Resources)
Morristown, NJ · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Morristown, NJ · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Villa Park, IL · On-site
$115K/yr
Perinatal RN Reviewer must be able to professionally and effectively communicate survey results to health care organization leadership in a constructive and collegial style. * Perinatal RN Reviewer ...
Villa Park, IL · On-site
$115K/yr
Perinatal RN Reviewer must be able to professionally and effectively communicate survey results to health care organization leadership in a constructive and collegial style. * Perinatal RN Reviewer ...
Saint Louis, MO · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Saint Louis, MO · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Des Moines, IA · On-site
Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient ... Registered Nurse Registered Nurse graduated from an accredited program. Current unrestricted Iowa ...
Des Moines, IA · On-site
Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient ... Registered Nurse Registered Nurse graduated from an accredited program. Current unrestricted Iowa ...
Saint Petersburg, FL · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
Saint Petersburg, FL · On-site
Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...
$28.37 - $29.68
12% of jobs
$29.68 - $30.99
4% of jobs
$30.99 - $32.30
3% of jobs
$32.30 - $33.61
3% of jobs
$33.81 is the 25th percentile. Wages below this are outliers.
$33.61 - $34.92
16% of jobs
$34.92 - $36.23
6% of jobs
The median wage is $37.22 / hr.
$36.23 - $37.54
6% of jobs
$37.54 - $38.85
10% of jobs
$38.85 - $40.17
1% of jobs
$40.94 is the 75th percentile. Wages above this are outliers.
$40.17 - $41.48
22% of jobs
$41.48 - $42.79
16% of jobs
$28
$37
$42
| Aspect | Rn Nurse Reviewer | Medical Reviewer |
|---|---|---|
| Credentials | Registered Nurse (RN) license, nursing certifications | Medical degree or nursing license, specialized medical certifications |
| Work Environment | Healthcare facilities, insurance companies, review organizations | Hospitals, insurance companies, healthcare consulting firms |
| Employer & Industry | Insurance companies, healthcare agencies, legal firms | Insurance companies, healthcare organizations, legal firms |
| Primary Focus | Reviewing medical records from a nursing perspective | Assessing medical records for accuracy and compliance from a clinical perspective |
Both Rn Nurse Reviewers and Medical Reviewers evaluate medical records, but Rn Nurse Reviewers focus on nursing aspects and patient care, while Medical Reviewers have broader medical expertise. The roles often overlap in insurance and healthcare settings, with the main difference being the scope of medical knowledge applied.
Cities with the most Rn Nurse Reviewer job openings:
States with the most job openings for Rn Nurse Reviewer jobs include:
The top searched job categories for Rn Nurse Reviewer jobs are:
$35 - $37/hr
Other
Medical, Dental, Vision, Life, Retirement, PTO
This job post has expired 3 days ago. Applications are no longer accepted.
Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in Service Operations position is a crucial role in our organization. In this role, you are responsible for coaching, mentoring, evaluating and developing the RN team. The Lead RN Reviewer will use established operational tools to ensure all RN staff are meeting or exceeding performance metrics and quality standards established by the leadership team.
As a Lead RN Reviewer, you will work closely with the leadership team and report to the Clinical Supervisor of Service Operations. You will be responsible for providing supervision for the RN Reviewers to meet or exceed operational objectives and metrics. You will leverage both your creative skills and communication skills to promote a high performing clinical team. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities.
What you'll do:
What you'll need:
Pay & Perks:
Fully remote opportunity with about 5% travel
Medical, dental, vision, life, disability insurance, and Employee Assistance Program
401K retirement plan with company match; flexible spending and health savings account
Up to 184 hours (23 days) of PTO per year + company holidays
Up to 14 weeks of paid parental leave
Pet insurance
The salary range for this position is $35 to $37 hourly; as part of a total benefits package which includes health insurance, 401k and bonus. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.
Interview Process*:
*Subject to change
About Cohere Health:
Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members.
With the acquisition of ZignaAI, we've further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validateâ„¢, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
Cohere Health's innovations continue to receive industry wide recognition. We've been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes.
The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal.
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Software development
51 - 200 Employees
Boston, MA, US
2019