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How much do clinical chart reviewer jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for clinical chart reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

What is a clinical chart reviewer?

A Clinical Chart Reviewer is responsible for evaluating medical records to ensure accuracy, compliance, and quality of documentation. They review patient charts for completeness, coding correctness, and adherence to healthcare regulations. This role is essential for improving patient care, supporting insurance claims, and minimizing documentation errors. Clinical Chart Reviewers often work for hospitals, insurance companies, or healthcare auditing firms. Strong knowledge of medical terminology, coding (ICD-10, CPT), and compliance guidelines is required.

What are the typical responsibilities of a clinical chart reviewer?

A Clinical Chart Reviewer is responsible for analyzing patient medical records to ensure completeness, accuracy, and compliance with established guidelines. Daily tasks often include reviewing documentation for correct coding, verifying that records meet regulatory standards, and identifying discrepancies or incomplete information that require follow-up. Clinical Chart Reviewers frequently collaborate with healthcare providers and coding staff to resolve any documentation issues or clarify medical details. This role requires consistent attention to detail and effective time management, as timely reviews are crucial for reimbursement, quality reporting, and maintaining patient care standards.

What are the key skills and qualifications needed to thrive as a clinical chart reviewer?

To thrive as a Clinical Chart Reviewer, you need a comprehensive understanding of medical terminology, clinical documentation practices, and healthcare regulations, often supported by a background in nursing or health information management. Familiarity with electronic health records (EHR) systems and coding software such as ICD-10 or CPT, as well as certifications like RHIA or CCS, is highly valuable. Strong attention to detail, analytical thinking, and effective communication are essential soft skills in this role. These abilities ensure accurate, compliant, and timely review of clinical documentation, which is critical for patient care quality and proper billing.

How to become a clinical chart reviewer?

To become a clinical chart reviewer, candidates typically need a healthcare background such as nursing, medical assisting, or health information management. Relevant skills include attention to detail, knowledge of medical terminology, and familiarity with electronic health records (EHR) systems. Some positions may require certification or experience in medical coding or auditing.
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Clinical Chart Reviewer jobs near you
Infographic showing various Clinical Chart Reviewer job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Temporary. Highlights an 78% In-person, and 22% Remote job distribution, with an average salary of $74,707 per year, or $35.9 per hour.

Compliance Lead - RCM & Clinical Documentation (Clinical Background Required)

Essen Medical Associates

Bronx, NY • On-site, Remote

$75K - $90K/yr

Full-time

Re-posted 13 days ago

Essen Health Care rating

4.6

Company rating: 4.6 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Overview
Company Overview: At Essen Health Care, we care for that!
Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state's most vulnerable and underserved residents. Founded in 1999, we've grown to 50+ locations and 600+ providers delivering urgent care, primary care, specialty services, nursing home support, and in-home care - guided by a Population Health model across in-person, home, and telehealth settings.
Job Summary
Position Title: Operational Compliance Lead - RCM & Clinical Documentation (Clinical Background Required)
Reporting to: Chief Administrative Officer
Scope: Essen Health Care & Nursing Home Division only
Job Summary: The Operational Compliance Lead is an embedded, frontline role managing day-to-day RCM and clinical operations compliance within Essen Health Care and its Nursing Home division. This is a hands-on operational position - distinct from the corporate compliance function - focused on identifying, correcting, and monitoring coding and billing accuracy before issues escalate to external review. Drawing on a clinical background (IMG preferred) and coding expertise, this Lead works directly with administrative and clinical operations leaders to drive documentation integrity, prevent CMS or state audit exposure, and ensure the organization is always audit-ready.
Responsibilities
Operational Compliance & Chart Review
  • Conduct routine and targeted clinical chart reviews and RCM audits assessing coding accuracy, billing integrity, and documentation completeness across CMS and state-billed services.
  • Proactively monitor for compliance risk patterns; generate ongoing trend reports to flag issues before they escalate to external review.
  • Identify coding discrepancies and billing vulnerabilities with focus on ICD-10-CM, CPT, E&M level selection, and Medical Decision Making (MDM) accuracy.
  • Develop, own, and drive Corrective Action Plans (CAPs) to confirmed completion, including re-audit to validate sustained improvement.

Clinical Coding & RCM Collaboration
  • Apply clinical knowledge to review documentation with a clinician's lens - ensuring diagnoses, MDM, and services support the codes being billed.
  • Work directly with admin and clinical operations leaders on ICD-10-CM, CPT, E&M, HCPCS, and HCC/risk adjustment coding accuracy.
  • Serve as the operational compliance liaison to RCM - bridging clinical documentation, coding, and billing to ensure alignment and defensibility.

Provider & Leadership Education
  • Deliver targeted, clinically grounded education to physicians, NPs, PAs, and staff on documentation best practices and coding compliance.
  • Develop training content on coding standards and payer-specific regulatory requirements as guidelines evolve.

Reporting & CAP Management
  • Produce executive-ready compliance trend reports and audit summaries that inform leadership decisions and prioritize risk.
  • Present CAPs to clinical and administrative leadership with clear timelines, owners, and success metrics - then own follow-through to resolution.
  • Act as the first line of resolution before issues surface at the corporate compliance level; maintain continuous audit readiness.

Qualifications
Qualifications
Required
  • Bachelor's Degree in Healthcare Administration, Nursing, Health Information Management, Public Health, or related field.
  • Clinical background required; International Medical Graduate (IMG) or foreign medical degree highly valued.
  • Active coding certification: CPC, CRC, CCS, or equivalent.
  • Minimum 3 years of operational compliance, coding, clinical chart review, or RCM experience; demonstrated ability to develop and close out CAPs.
  • Strong knowledge of ICD-10-CM, CPT, HCPCS, HCC/Risk Adjustment, Medicare/Medicaid regulations, and HIPAA.
  • Demonstrated ability to present audit findings and CAPs to senior leadership; comfortable owning follow-through to resolution.

Preferred
  • Master's Degree (MHA, MPH, MBA with healthcare focus, MSN, or equivalent) - strongly preferred given the organizational complexity and cross-functional leadership demands of this role.
  • Project management experience or certification (PMP, CAPM, or equivalent).
  • Experience in Medicare Advantage, value-based care, and/or Clinical Documentation Improvement (CDI).
  • Experience with eClinicalWorks (eCW) or similar EMR systems.
  • Prior experience providing provider education and compliance training.

Core Competencies
Clinical Documentation Integrity • Compliance Auditing • RCM & Revenue Integrity • Provider Education & Coaching • HCC/Risk Adjustment Coding • CAP Development & Closure • Regulatory Compliance • Data Analysis & Reporting • Project Management • Cross-Functional Collaboration
Work Environment
  • Full-time | Hybrid or on-site based on business needs | Travel between clinical locations may be required.

Why Join Essen Health Care?
The Operational Compliance Lead plays a uniquely important role at the intersection of clinical knowledge, coding expertise, and operational leadership. This is not a corporate oversight role - it is a proactive, hands-on position embedded within Essen Health Care and Nursing Home operations to identify and resolve compliance issues at the source, before they reach external review. If you are a clinically trained professional who understands how care is delivered and how it must be accurately documented and billed, this is a role where your expertise will have immediate, measurable impact.
Equal Opportunity Employer
Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

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