Remote Clinical Reviewer Jobs
Remote clinical reviewer jobs are in active demand across the U.S., with remote-first firms and distributed healthcare, insurance, and managed care teams hiring for these roles year-round. Employers hiring remotely right now include Dane Street, AWG, and CorroHealth. See the openings below and apply to the ones that match your experience.
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Showing 5 of 8+ Remote Clinical Reviewer jobs
Job Description
A bit about this role:
A licensed dental hygienist will play a vital role within Devoted Health's Clinical Operations team by performing first-level clinical reviews of dental claims and pre-treatment estimates using established clinical guidelines, policies, and delegated authority. This position ensures accurate, timely, and compliant utilization management while supporting high-quality, compassionate care and strong relationships with dental providers.
Schedule: The position follows a five-day, eight-hour work schedule, totaling 40 hours per week. Shifts are scheduled within the hours of 8:00 AM–8:00 PM ET and will include weekend and Holiday rotation coverage.
Your Responsibilities and Impact will include:
- First-Level Clinical Evaluation: Review assigned dental claims and pre-treatment estimates requiring clinical evaluation, approving claims that meet clinical, contractual, and documentation requirements.
- Documentation & Image Review: Evaluate radiographs, dental charting, narratives, treatment records, and claim histories using evidence-based guidelines and clinical expertise.
- Case Referral & Coordination: Refer complex cases, potential denials, or adverse benefit determinations to Dental Advisors or designated clinical authorities for final determination (the Dental Hygienist Clinical Reviewer does not deny authorizations).
- Documentation & System Entry: Identify required documentation for clinical review, clear processing instructions, and document review findings accurately in claims systems.
- Coding & Policy Application: Consistently apply ADA CDT coding knowledge, dental terminology, clinical documentation standards, and contractual provisions.
- Quality & Escalation: Identify and escalate unusual practice patterns, utilization trends, potential fraud, waste, or abuse concerns, policy gaps, or workflow issues.
- Cross-Functional Collaboration: Collaborate with Dental Advisors, Claims, Provider Relations, and team leads to support smooth operations and constructive provider communications.
- Compliance: Maintain full compliance with HIPAA, privacy standards, organizational policies, and regulatory requirements.
Required skills and experience:
- 5+ years of clinical experience as a dental hygienist in a private practice or comparable dental healthcare setting. Dental claims review or utilization management experience is a plus.
- Active Registered Dental Hygienist (RDH) license or relevant clinical dental credential in good standing.
- Strong working knowledge of ADA CDT coding, dental terminology, dental procedures, and clinical documentation.
- Demonstrated ability to read and interpret dental radiographs, charting, clinical narratives, and treatment records.
- Excellent analytical, organizational, communication, and problem-solving skills with high attention to detail.
- Proficiency with claims-processing systems, electronic health/dental records, and standard digital tools.
- Experience with technology-enabled workflow improvements, particularly with AI/LLM tools.
Desired skills and experience:
- Prior experience in dental insurance claims review, utilization management, or health plan clinical operations, ideally within a Medicare Advantage or managed care setting.
#LI-remote
Salary range: $58,000 - $75,000 annually
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....
- Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
We have been made aware of instances of fraudulent job postings and/or fraudulent recruiting activity by individuals purporting to represent Devoted Health. These fraudulent schemes often seek monetary contributions or payments from job seekers (such as for “start up costs” or “equipment”), or seek to collect sensitive personal information. These job postings and offers are NOT authorized by Devoted Health and Devoted is not responsible for fraudulent offers, personal information that you may have disclosed, or payments made to third parties purporting to represent Devoted. We have reported this matter and are cooperating with law enforcement agencies. Devoted Health will never ask for financial commitment or contribution from a candidate at any stage of the recruitment process.
Job Description
A bit about this role:
A licensed dental hygienist will play a vital role within Devoted Health's Clinical Operations team by performing first-level clinical reviews of dental claims and pre-treatment estimates using established clinical guidelines, policies, and delegated authority. This position ensures accurate, timely, and compliant utilization management while supporting high-quality, compassionate care and strong relationships with dental providers.
Schedule: The position follows a five-day, eight-hour work schedule, totaling 40 hours per week. Shifts are scheduled within the hours of 8:00 AM–8:00 PM ET and will include weekend and Holiday rotation coverage.
Your Responsibilities and Impact will include:
- First-Level Clinical Evaluation: Review assigned dental claims and pre-treatment estimates requiring clinical evaluation, approving claims that meet clinical, contractual, and documentation requirements.
- Documentation & Image Review: Evaluate radiographs, dental charting, narratives, treatment records, and claim histories using evidence-based guidelines and clinical expertise.
- Case Referral & Coordination: Refer complex cases, potential denials, or adverse benefit determinations to Dental Advisors or designated clinical authorities for final determination (the Dental Hygienist Clinical Reviewer does not deny authorizations).
- Documentation & System Entry: Identify required documentation for clinical review, clear processing instructions, and document review findings accurately in claims systems.
- Coding & Policy Application: Consistently apply ADA CDT coding knowledge, dental terminology, clinical documentation standards, and contractual provisions.
- Quality & Escalation: Identify and escalate unusual practice patterns, utilization trends, potential fraud, waste, or abuse concerns, policy gaps, or workflow issues.
- Cross-Functional Collaboration: Collaborate with Dental Advisors, Claims, Provider Relations, and team leads to support smooth operations and constructive provider communications.
- Compliance: Maintain full compliance with HIPAA, privacy standards, organizational policies, and regulatory requirements.
Required skills and experience:
- 5+ years of clinical experience as a dental hygienist in a private practice or comparable dental healthcare setting. Dental claims review or utilization management experience is a plus.
- Active Registered Dental Hygienist (RDH) license or relevant clinical dental credential in good standing.
- Strong working knowledge of ADA CDT coding, dental terminology, dental procedures, and clinical documentation.
- Demonstrated ability to read and interpret dental radiographs, charting, clinical narratives, and treatment records.
- Excellent analytical, organizational, communication, and problem-solving skills with high attention to detail.
- Proficiency with claims-processing systems, electronic health/dental records, and standard digital tools.
- Experience with technology-enabled workflow improvements, particularly with AI/LLM tools.
Desired skills and experience:
- Prior experience in dental insurance claims review, utilization management, or health plan clinical operations, ideally within a Medicare Advantage or managed care setting.
#LI-remote
Salary range: $58,000 - $75,000 annually
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....
- Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
We have been made aware of instances of fraudulent job postings and/or fraudulent recruiting activity by individuals purporting to represent Devoted Health. These fraudulent schemes often seek monetary contributions or payments from job seekers (such as for “start up costs” or “equipment”), or seek to collect sensitive personal information. These job postings and offers are NOT authorized by Devoted Health and Devoted is not responsible for fraudulent offers, personal information that you may have disclosed, or payments made to third parties purporting to represent Devoted. We have reported this matter and are cooperating with law enforcement agencies. Devoted Health will never ask for financial commitment or contribution from a candidate at any stage of the recruitment process.
See All 8 Remote Clinical Reviewer Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Clinical Reviewer JobsRemote Clinical Reviewer Job Market
Who's Hiring
What Employers Look For
The qualifications that appear most often in remote clinical reviewer jobs.
- Active RN, MD, or equivalent clinical license in good standing
- Minimum two years of direct patient care or acute care experience
- Working knowledge of InterQual or MCG clinical criteria
- Experience with utilization review, prior authorization, or case management
- Familiarity with ICD-10 coding and medical terminology
- Strong written communication skills for documenting clinical rationale
Tips for Your Remote Clinical Reviewer Job Search
Apply early to remote roles that fit
Migrate Mate lists remote clinical reviewer openings from across the U.S. in one place, so you can find roles that match your licensure, specialty, and schedule and apply directly without sorting through mixed listings.
Show your async documentation skills upfront
Remote clinical reviewer hiring managers screen for written clarity before anything else. Rewrite your resume's experience bullets to reflect case volume, turnaround accuracy, and criteria systems you used, like InterQual or Milliman, so your ability to work independently reads clearly without an interview.
Target utilization management and health plan roles
Remote clinical reviewer demand is highest inside utilization management vendors, managed care organizations, and health plans. Search specifically for prior authorization reviewer, UM nurse reviewer, and clinical appeals reviewer titles, since these remote-heavy functions are where distributed hiring concentrates.
Prepare for asynchronous remote interviews
Many distributed healthcare employers use recorded video or written case-scenario screens before a live interview. Practice walking through a denial rationale or a clinical criteria decision in writing, because remote teams are evaluating your judgment and communication together from the first screen.
Remote Clinical Reviewer Jobs: Frequently Asked Questions
How do I get a remote clinical reviewer job?
Start by targeting companies that already run distributed clinical teams, including managed care organizations, utilization management firms, telehealth companies, and health plan administrators. Remote employers screen for strong written communication, the ability to work through clinical cases independently without in-person oversight, and familiarity with InterQual or Milliman criteria. Demonstrating a history of self-directed work and clear documentation habits gives you a real edge over candidates with equal clinical experience.
Can you get a remote clinical reviewer job with no experience?
Yes, but remote entry-level clinical reviewer roles are harder to land because employers expect you to handle cases independently from day one without in-person mentorship. Your strongest path in is through telehealth startups or utilization management firms that hire newer clinicians. Showing completed continuing education in utilization review, any case management coursework, and a clean record of documentation quality in prior clinical roles will open doors faster than a general application.
Do you need a degree for remote clinical reviewer jobs?
Usually, but the specific degree matters more than the level. Most remote employers require an active clinical license, which typically implies a nursing or allied health degree, rather than a standalone academic credential. Remote hiring teams weigh your licensure status, hands-on clinical background, and demonstrated ability to apply evidence-based criteria consistently, so a strong clinical record often carries more weight than advanced academic credentials alone.
See All 8 Remote Clinical Reviewer Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Clinical Reviewer Jobs