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Healthcare Administration

Remote RN: Medical Reviewer II – Claims & Utilization

Remote / Online - Candidates ideally in
Wyoming, Hamilton County, Ohio, USA
Listing for: CGS Administrators LLC
Remote/Work from Home position
Listed on 2026-03-03
Job specializations:
  • Healthcare
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below
A leading healthcare review organization seeks a Medical Reviewer who will perform medical claim reviews and provide support in utilization practices. The position requires an active RN license and two years of clinical nursing experience. You will monitor process timeliness and document medical rationale for claims decisions.

This role offers a hybrid work schedule for qualified candidates. We value a diverse, inclusive workforce, and offer a comprehensive benefits package including health plans and a retirement savings plan.
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