Nurse Reviewer (LPN/RN)

Nurse Reviewer (LPN/RN)

Pay rate: $27.50/hr W2 Location: Fully Remote - US Only Assignment: September 2026 through February 2027 (initial 5 months, Potential for extension/conversion based on business needs and performance) License Requirement: Active LPN or RN license in good standing throughout the entire assignment period.

Key Responsibilities:

As a Nurse Reviewer, you'll play a key role in supporting disability claims by evaluating medical information and helping facilitate successful return-to-work outcomes. Responsibilities include:

• Review medical records, treatment plans, and disability claims (STD/LTD/FMLA)
• Assess functional capacity and determine medical necessity based on clinical documentation
• Correlate job duties with medical restrictions and disability guidelines
• Provide clinical recommendations regarding functional abilities and return-to-work planning
• Develop and coordinate goal-focused Return-to-Work plans
• Collaborate with claimants, physicians, employers, and claim specialists
• Educate claims teams on medical and disability-related topics
• Identify barriers to returning to work and recommend appropriate interventions
• Maintain accurate documentation while ensuring compliance with company policies and confidentiality standards
• Participate in special projects and ongoing professional development

Qualifications:

• Active LPN or RN license in good standing
• Minimum 3 years of clinical nursing experience working with adult patients

Preferred Experience:

• Disability Insurance
• Workers' Compensation
• Case Management
• Occupational Health
• Rehabilitation Medicine
• Home Health
• Utilization Review or Medical Review

Must-Have Skills:

• Strong clinical assessment and critical thinking skills
• Excellent written and verbal communication
• Ability to analyze medical records and make sound clinical recommendations
• Knowledge of medical terminology, CPT, and ICD coding
• Ability to prioritize workload, meet deadlines, and work independently
• Proficient with multiple computer systems and technology

Education:

• Associate degree required
• Bachelor's Degree preferred