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From Home Remote Rn Chart Review Jobs in Oregon (NOW HIRING)

Broadway Ventures

Medical Claims Reviewer (RN)

OR · Remote

S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a private ... Review medically complex claims , pre-authorization requests, appeals, and fraud/abuse referrals.

Centene

RN Supervisor, Appeals, Managed Care, UM

OR · On-site +1

$75K - $135K/yr

REMOTE RN candidates may reside in any state but a current and active RN license from the state of California is strongly preferred Position Purpose: Supervises Prior Authorization, Concurrent Review ...

firsthand Health

Remote Triage Nurse

Eugene, OR · Remote

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support ... Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately ...

firsthand Health

Remote Triage Nurse

Eugene, OR · On-site +1

$80K/yr

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support ... Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Boulder Care

Registered Nurse (Telehealth/SUD)

OR · Remote

This is a 100% remote, full-time, W2 position. We are looking for RNs who: * Have an active ... Obtain and review drug testing results and recommend further testing as appropriate, guided by ...

Precoa

Inside Sales Representative - Remote

Portland, OR · On-site +1

What if you could have an impactful sales career working from home without the pressure of knocking door-to-door or visiting client businesses? As an Inside Sales Representative (remote) with Precoa ...

Aveanna Healthcare

Registered Nurse (Rn)

Portland, OR · On-site +1

$48 - $55/hr

Registered Nurse - RN We are one of the largest private duty nursing companies in the nation and ... 7 Local support from operators and clinicians * Aveanna has a tablet in each patient's home ...

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From Home Remote Rn Chart Review information

What is the difference between From Home Remote Rn Chart Review vs From Home Remote LPN Chart Review?

AspectFrom Home Remote Rn Chart ReviewFrom Home Remote LPN Chart Review
Required CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote, home-basedRemote, home-based
Job ResponsibilitiesComprehensive chart review, clinical decision supportBasic chart review, data entry
Industry UsageHospitals, insurance companies, healthcare providers

While both roles involve remote chart review, Rn Chart Review requires an RN license and involves more complex clinical assessments, whereas LPN Chart Review requires an LPN license with more routine data review tasks. The RN role typically offers higher responsibility and pay, reflecting the advanced clinical skills needed.

What are popular job titles related to From Home Remote Rn Chart Review jobs in Oregon? For From Home Remote Rn Chart Review jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching From Home Remote Rn Chart Review jobs in Oregon look for? The top searched job categories for From Home Remote Rn Chart Review jobs in Oregon are:
What cities in Oregon are hiring for From Home Remote Rn Chart Review jobs? Cities in Oregon with the most From Home Remote Rn Chart Review job openings:
From Home Remote Rn Chart Review jobs near you
Infographic showing various From Home Remote Rn Chart Review job openings in Oregon as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 23% Part Time, and 4% Contract. Highlights an 79% Physical, 1% Hybrid, and 20% Remote job distribution.

Medical Claims Reviewer (RN)

Broadway Ventures

OR • Remote

Other

Re-posted 21 days ago

Job description

Job Type: Full-time (40 hours/week)
Schedule: Monday-Friday, 8:00 AM - 5:00 PM

Max Salary: W-2 ($60,000-$63,000)

Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience plus at least two years in one of the following:
    • Home Health (meets for both clinical and HH requirement for a total of 2 years)
    • Utilization/Medical Review
    • Quality Assurance
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
Preferred Qualifications
  • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
  • Proficiency in using multiple screens and software programs simultaneously.

If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!

Apply