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Epiq

Nurse Reviewer

Posted 19 Days Ago
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Remote
Hiring Remotely in Ontario, ON, CAN
Mid level
Remote
Hiring Remotely in Ontario, ON, CAN
Mid level
Reviews medical claims for compliance with company policies and legal practices, prepares management reports, maintains source documentation, and communicates with clients and team members. The role requires a bachelor’s degree in nursing or a related field and 3–5 years of medical claims review experience. RN, CPHQ, and LNCC certifications are preferred but not required.
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At Epiq, your work contributes to complex, global legal outcomes. You’ll join a values‑driven community where integrity guides decisions, relentless service sets the bar, and we thrive on big challenges together. We invest in your growth with enterprise‑wide learning and mobility. We celebrate who you are, and we respect life beyond work with flexibility that’s recognized externally. Enabled by modern platforms and AI, you’ll do the most meaningful work of your career and see your impact at scale.

Job Description:

Job Summary

The Nurse Reviewer is responsible for reviewing medical claims, ensuring compliance with company policies and legal practices. This role requires strong communication, confidentiality, and analytical skills.

Essential Job Responsibilities

  • Review medical claims and ensure compliance with company policies and legal practices.

  • Conduct management reporting and maintain source documents.

  • Communicate effectively with clients and team members.

  • Maintain professional etiquette and organizational abilities.

Qualifications & Requirements

Education: 

  • Bachelor's degree in nursing or a related field.

Experience: 

  • 3-5 years of experience in medical claims review or a related role.

Skills:

  • Communication

  • Company Policies

  • Confidentiality

  • Languages

  • Legal Practices

  • Management Reporting

  • Source Documents

  • Standard Operating Procedure (SOP)

  • Supervision

  • Written Communication

Certifications:

  • Required: None

  • Preferred: Registered Nurse (RN) License, Certified Professional in Healthcare Quality (CPHQ), Legal Nurse Consultant Certified (LNCC)

Physical Requirements: 

  • Ability to work in an office environment and perform tasks that may require sitting, standing, and using office equipment.

Your specific salary will be determined based on several factors:

  • Location-based market rate for the role

  • Your abilities in relation to the job specification

  • Performance during screening and interview

  • Pay parity with the wider team in the considered location

Further details about the package will be provided during the initial screening call with the Talent Acquisition Team.

Click here to learn about Epiq's Benefits.

Epiq Leadership Compass

Fosters Relationships & Collaboration

Builds trust and alignment through open communication, shared goals, and strong partnerships to drive collective success.

  • Build trust-based partnerships

  • Nurture long-term relationships

  • Remove collaboration barriers

  • Celebrate cross-team success

Engages & Influences

Inspires action and alignment through clear communication, purposeful influence, and a compelling vision.

  • Use storytelling to build buy-in

  • Align communication with organizational goals

  • Guild alignment through strong engagement

Maximizes Performance

Sets and reinforces performance standards that drive results, ensure accountability, and align with Epiq’s goals.

  • Use data to identify improvement opportunities

  • Make informed decisions

  • Align team goals with boarder strategy

  • Empower teams to manage their own goals

  • Translate vision into clear priorities

  • Prepare for disruptions with strong change management

Achieves Operational Success

Drives continuous improvement and operational excellence through smart processes, data insights, and quality execution.

  • Improve workflows for team efficiency

  • Use clear documentation and expectations

  • Resolve issues quickly using data and feedback

It is Epiq’s policy to comply with all applicable equal employment opportunity laws by making all employment decisions without unlawful regard or consideration of any individual’s race, religion, ethnicity, color, sex, sexual orientation, gender identity or expressions, transgender status, sexual and other reproductive health decisions, marital status, age, national origin, genetic information, ancestry, citizenship, physical or mental disability, veteran or family status or any other basis protected by applicable national, federal, state, provincial or local law. Epiq’s policy prohibits unlawful discrimination based on any of these impermissible bases, as well as any bases or grounds protected by applicable law in each jurisdiction. In addition Epiq will take affirmative action for minorities, women, covered veterans and individuals with disabilities. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. Epiq is pleased to provide such assistance and no applicant will be penalized as a result of such a request.  Pursuant to relevant law, where applicable, Epiq will consider for employment qualified applicants with arrest and conviction records.

Epiq Toronto, Ontario, CAN Office

44 Victoria Street, Suite 900, Toronto, Canada, M5C 1Y2

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