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Full Time Remote Rn Chart Review Jobs in Maryland

Manulife

Suitability Review Specialist

California, MD · Remote

$73K - $122K/yr

The Specialist serves as a trusted resource to registered representatives, field agents, and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

Manulife

$73K - $122K/yr

The Specialist serves as a trusted resource to registered representatives, field agents, and ... Referenced Salary Location USA, Massachusetts - Full Time Remote Working Arrangement Remote Salary ...

New

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

Registered Nurse, with a current unobstructed license to practice nursing in the United States ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

Registered Nurse, with a current unobstructed license to practice nursing in the United States ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

J29 Inc.

Medical Reviewer, RN

Millersville, MD · On-site +1

Medical Reviewer, RN About J29 J29, Inc. (J29) has been supporting commercial, State, and Federal ... Our team of 260 employees focuses on providing processing, review, and analysis of medical claims ...

Cinqcare

Registered Nurse

Laurel, MD · Remote

Deploys Remote Patient Monitoring and Patient Self Reporting for High-Risk Chronic Conditions ... The RN will establish the business strategy and roadmap: (1) improve outcomes for Grace at Home ...

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All JobsRn Chart Review JobsFull Time Remote Rn Chart Review JobsFull Time Remote Rn Chart Review Jobs in Maryland

Full Time Remote Rn Chart Review information

What is the difference between Full Time Remote Rn Chart Review vs Full Time Remote LPN Chart Review?

AspectFull Time Remote Rn Chart ReviewFull Time Remote LPN Chart Review
CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote, healthcare documentation reviewRemote, healthcare documentation review
Industry UsageCommon in healthcare, insurance, and legal sectorsLess common, primarily in healthcare documentation
Job FocusDetailed medical record review, complex case analysisBasic record review, data entry, and documentation

While both roles involve remote healthcare documentation review, RNs typically handle more complex cases requiring clinical expertise, whereas LPNs focus on more routine record reviews. The choice depends on your credentials and desired level of clinical involvement.

What cities in Maryland are hiring for Full Time Remote Rn Chart Review jobs? Cities in Maryland with the most Full Time Remote Rn Chart Review job openings:
Full Time Remote Rn Chart Review jobs near you

DRG Coder, Registered Nurse

Pivotal Placement Services

Baltimore, MD • Remote

$95K - $105K/yr

Full-time

Posted 4 days ago

Job description

DRG Coder, Registered Nurse

📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding

About the Role

We are seeking an experienced DRG Coder / Clinical Auditor (RN) to conduct comprehensive DRG quality and validation audits of inpatient medical records. This role is critical in ensuring accurate DRG assignment, strong clinical documentation support, and compliance with Medicare and CMS regulations. The ideal candidate is highly analytical, clinically strong, and comfortable working independently in a production-driven audit environment.

You will play a key role in improving coding accuracy, reimbursement integrity, and regulatory compliance while providing clear, defensible audit findings.

Key ResponsibilitiesDRG Validation & Chart Review
  • Perform in-depth DRG quality audits of inpatient medical records.
  • Validate DRG assignments against clinical documentation and coding guidelines.
  • Identify missed opportunities, discrepancies, and documentation gaps impacting reimbursement.
Clinical Documentation Review
  • Evaluate physician documentation to ensure clinical indicators appropriately support assigned diagnoses and procedures.
  • Apply strong clinical judgment to assess severity of illness, risk of mortality, and DRG impact.
Audit & Compliance
  • Ensure compliance with Medicare, CMS, and payer-specific documentation and coding requirements.
  • Identify trends, risks, and improvement opportunities related to DRG accuracy and quality.
  • Support organizational initiatives focused on audit accuracy, compliance, and revenue integrity.
Coding Expertise
  • Apply extensive hands-on knowledge of ICD-10-CM and ICD-10-PCS, Coding Clinic guidance, and Official Coding Guidelines.
  • Utilize MS-DRG and APR-DRG methodologies when reviewing and validating records.
Communication & Reporting
  • Document audit findings clearly, concisely, and professionally.
  • Communicate results and rationale effectively to internal stakeholders as required.
Additional Duties
  • Support other documentation, coding, and audit-related activities as assigned.
Required QualificationsLicensure
  • Active Registered Nurse (RN) license required
    (Non-RN candidates will not be considered)
Experience
  • Minimum of 2 years of recent DRG quality auditing experience in a hospital or health plan setting.
  • Extensive hands-on inpatient ICD-10-CM and ICD-10-PCS coding experience required.
Certifications
  • National coding certification required (AHIMA or AAPC).
  • CCS, CIC, or equivalent strongly preferred.
Technical Knowledge
  • Proficiency in Medicare and CMS documentation and coding guidelines.
  • Strong understanding of MS-DRG and APR-DRG methodologies.
  • Advanced familiarity with Coding Clinic citations and Official Coding Guidelines.
Soft Skills
  • Exceptional attention to detail and analytical accuracy.
  • Strong critical thinking and problem-solving skills.
  • Clear, professional written and verbal communication.
  • Ability to work independently in a fast-paced, production-driven environment.
Tools
  • Proficient in Microsoft Office Suite (Excel, Word, Outlook).
Compensation

💵 Pay Range: $90,000 – $104,841

Compensation is based on location, experience, qualifications, and internal equity. Final compensation may vary following the interview and assessment process.

Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm specializing in healthcare talent—from frontline staff to executive leadership—in both clinical and non-clinical roles. We deliver customer-focused staffing solutions through Direct Placement and MSP/VMS partnerships nationwide.