Work from home RN insurance professionals may hold a number of different job titles, including clinical review nurse, utilization review nurse, nurse case manager, and triage nurse. A clinical review nurse reviews the appeals and grievances filed by providers and members. A remote nurse case manager’s duties include performing initial case evaluations, working as a liaison for everyone involved in a given claim, and managing a caseload. The responsibilities of a triage nurse include initiating contact with clients, securing medical documentation about procedures and treatments, and determining if the client is able to return to work. A utilization review nurse audits a patient’s care and determines if coverage is adequate. They also determine medical necessity regarding medical care.