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Medical Malpractice Chart Review Jobs in Springfield, MA

Trinityhealth

Medical Assistant - OB/GYN

Hartford, CT

$18 - $23/hr

This Medical Assistant is responsible for preparing patients for office visits, performing tasks ... patients' chart after they have been reviewed by the physician. Assures accurate and complete ...

Trinity Health

Medical Assistant - OB/GYN

Hartford, CT

$18 - $23/hr

This Medical Assistant is responsible for preparing patients for office visits, performing tasks ... patients' chart after they have been reviewed by the physician. Assures accurate and complete ...

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All JobsMedical Malpractice Chart Review JobsMedical Malpractice Chart Review Jobs in Springfield, MA

Medical Malpractice Chart Review information

See Springfield, MA salary details

$49.3K

$67.7K

$87.7K

How much do medical malpractice chart review jobs pay per year?

As of Aug 6, 2026, the average yearly pay for medical malpractice chart review in Springfield, MA is $67,741.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,800.00 and $74,200.00 per year, depending on experience, location, and employer.

What are some common challenges faced during a medical malpractice chart review, and how can they be managed?

One of the main challenges in medical malpractice chart review is ensuring accuracy and thoroughness when analyzing complex patient records that may be incomplete or poorly documented. Reviewers must also remain objective and unbiased, especially when interpreting ambiguous notes or conflicting information. Successful reviewers often develop strong organizational skills, attention to detail, and the ability to communicate findings clearly with legal teams, healthcare providers, and other stakeholders. Staying updated with current medical standards and legal requirements also helps address these challenges effectively.

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

To excel as a Medical Malpractice Chart Reviewer, you need a solid clinical background (often as an RN, MD, or other licensed healthcare professional) and a strong understanding of medical-legal standards. Familiarity with electronic medical records (EMRs), chart auditing tools, and relevant certification such as Legal Nurse Consultant (LNC) or Certified Professional in Healthcare Risk Management (CPHRM) is highly beneficial. Critical thinking, keen attention to detail, and effective written communication are vital soft skills for analyzing records and preparing clear, objective reports. These competencies ensure accurate, thorough, and defensible chart reviews that support case outcomes in legal or insurance contexts.

What is the difference between Medical Malpractice Chart Review vs Medical Records Reviewer?

AspectMedical Malpractice Chart ReviewMedical Records Reviewer
CredentialsTypically requires healthcare background, licensure, and familiarity with legal standardsUsually requires healthcare or administrative background, often with certification in medical records management
Work EnvironmentLegal settings, law firms, or insurance companies reviewing medical records for malpractice casesHospitals, clinics, or insurance companies managing and organizing medical records
Industry UsagePrimarily in legal and insurance industries for malpractice case assessmentsIn healthcare and insurance sectors for record management and compliance

Medical Malpractice Chart Review involves analyzing medical records specifically for legal cases related to malpractice, requiring legal and medical knowledge. Medical Records Reviewer focuses on organizing and managing medical records within healthcare or insurance settings. While both roles handle medical records, the former emphasizes legal case evaluation, whereas the latter centers on record management and compliance.

What is medical malpractice chart review?

Medical malpractice chart review is the process of thoroughly examining a patient's medical records to determine whether the standard of care was met in a specific healthcare situation. This review is often conducted by medical professionals or legal nurse consultants in the context of investigating potential medical negligence or malpractice claims. The reviewer analyzes documentation, treatment decisions, and outcomes to identify any deviations from accepted medical practices. The findings can be used in legal cases, insurance claims, or quality assurance assessments.
What are popular job titles related to Medical Malpractice Chart Review jobs in Springfield, MA? For Medical Malpractice Chart Review jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Medical Malpractice Chart Review jobs in Springfield, MA look for? The top searched job categories for Medical Malpractice Chart Review jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Medical Malpractice Chart Review jobs? Cities near Springfield, MA with the most Medical Malpractice Chart Review job openings:
Medical Malpractice Chart Review jobs near you
Infographic showing various Medical Malpractice Chart Review job openings in Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $67,741 per year, or $32.6 per hour.

Center for Care Coordination-Team Lead Utilization Review Nurse- Full Time

Connecticut Children's

Hartford, CT • On-site

Full-time

Posted 11 days ago

Connecticut Children's Medical Center rating

7.7

Company rating: 7.7 out of 10

Based on 45 frontline employees who took The Breakroom Quiz

221st of 1,054 rated hospitals

Job description


The Team Lead for Utilization Review (UR) is responsible for the day-to-day activities and oversight of the UR Nurses, under the guidance and support of the Manager of Case Management and Director of the Center. Provides leadership and direction around scheduling, supervision and daily operations, while looking strategically at how workflow and process improvement can optimize and improve the role of Case Management and patient/family care through the institution. Lead will identify challenges and systems issues that need to be elevated to the Manager and Center Leadership.
Responsibilities
Team Lead-20%:
  • Daily clinical support and supervision of UR nurses.
  • Scheduling for UR coverage.
  • UR Policies and Procedure review and maintenance.
  • Onboarding and support of new staff.
  • Individual and team supervision / support following challenging cases.
  • Work with Manager to establish and track metrics, data and initiatives that improve process
  • UR Team Communications.
  • Assists Manager in completing performance evaluations.
  • Provides formal and informal support of members through engagement activities, team supervision and staff meetings.
  • Develop and maintain effective and efficient processes for determining the defensible hospitalization status based on regulatory and reimbursement requirements of various commercial and government payers. -20%
  • Performs chart review of assigned patients to identify quality, timeliness, and appropriateness of patient care. Conducts hospitalization reviews for Medicaid beneficiaries, as well as other insurers and self-pay patients, based on appropriate guidelines. Uses these criteria to screen for appropriateness of level of care based on medical record documentation. -9%
  • Gathers clinical information to conduct continued stay utilization review activities with payers pursuant to department policies and procedures and the Utilization Review Plan. -5%
  • Escalates cases as appropriate for secondary review. -5%
  • Performs concurrent and retrospective clinical reviews utilizing the appropriate guidelines as demonstrated by compliance with all applicable regulations, policies, and timelines. -5%
  • Adheres to CMS guidelines for utilization reviews as evidenced by utilization of the relevant guidelines and appropriate referrals for secondary review. Identifies, develops, and implements strategies to reduce length of stay and resource consumption in conjunction with discharge planning staff. -9%
  • Identifies and consistently documents information on any progression of care or patient flow barriers using the designated electronic tool used to track avoidable days/delays. -2.5%
  • Engages hospital case management and care team colleagues in collaborative problem solving regarding appropriate utilization of resources. -5%
  • Represents Utilization Management at various committees, as needed. -.5%
  • Identifies and records episodes of preventable delays or avoidable days due to failure of progression-of-care processes. 2

  • Maintains appropriate documentation in the Utilization software system on each patient to include specific information of all resource utilization activities. -10%
  • Provides consultation and education to physicians and other qualified practitioners regarding medical record documentation necessary to support the ordered level of care. -5%

  • Conveys benefit data and options, programs and other forms of assistance that may be available to the patient, and negotiates for services as indicated. -.5%
  • Communicates pertinent reimbursement information to healthcare team while observing patient right to confidentiality. -1.0%
  • Verifies in-network verses out-of-network benefits and communicates data to the patient and healthcare team as indicated. -.5%
  • Collaborates with other members of The Center team to coordinate the right care, in the right setting, at the right time for CT Children's patients.
  • Identify gaps in care/resources and address issues that negatively impact access to care, services, and resources
  • Function as a change agent, advocate, and resource person for family and healthcare team to identify and resolve performance improvement issues within the system. -5%
  • Performs other job-related duties as assigned 0

Qualifications
Education and/or Experience Required:
  • Education: Bachelor of Science in Nursing (BSN)
  • Experience: 3 years' nursing in a healthcare setting

Education and/or Experience Preferred:
  • Experience:
    • Pediatric nursing experience
    • Previous experience in Utilization Review
    • Previous experience in Case Management or Discharge planning

License and/or Certification Required:
  • State of Connecticut Nursing License

License and/or Certification Preferred:
  • Case Management Certification.

Knowledge, Skills and Abilities:
Knowledge:
  • Demonstrate working knowledge of how to interpret and apply medical care criteria.
  • Knowledge of community resources, treatment options, home health availability, funding options and special programs.
  • UR Team Lead has strong clinical skills and a well-developed knowledge of utilization management, with a focus on medical necessity determinations. Lead maintains current and accurate knowledge regarding commercial and government payers including regulatory requirements.

Skills:
  • Coordinates management of care for a specified patient population; follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with hospital standards
  • Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs.
  • Skilled in the operation of the computer including proficiency in Microsoft Office Word, ability to use/update Excel spreadsheets and ability to navigate EPIC.
  • Strong working knowledge of medical necessity tools such as InterQual® and Milliman Care Guidelines® and be proficient in medical record reviews.
  • UR Lead will support process improvement activities and report key metrics to facility leadership as requested.
  • The UR Lead will demonstrate an ability to effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment.
  • Lead will provide support to the hospital's UM Committee as needed and collaborate with multiple leaders at various levels throughout the organization.

Abilities:
  • Self-directed/motivated, organized, diplomatic and team-oriented.
  • Function in a high energy, fast moving environment.
  • Maintain flexibility as determined by acuity of medical unit.
  • Prioritize case load.
  • Collaborate with various disciplines
  • Communicate effectively and efficiently
  • Prioritize and manage multiple tasks.
  • Excellent written and verbal communication skills.

About Us
Connecticut Children's is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children's offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members.
At Connecticut Children's, treating children isn't just our job - it's our passion. As a leading children's health system experiencing steady growth, we're excited to expand our team with exceptional team members who share our vision of transforming children's health and well-being as one team.

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