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Medical Review Rn Jobs (NOW HIRING)

Lancesoft INC

Utilization Review RN

Atlanta, GA · On-site

$3.0K - $3.1K/wk

Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company Description LanceSoft is rated as one of the largest staffing firms in the US by ...

Broadway Ventures

Medical Claims Reviewer (RN)

OR · Remote

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 ...

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How much do medical review rn jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for medical review rn in the United States is $44.91, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $53.37 per hour, depending on experience, location, and employer.

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

Can I make $500,000 as a nurse?

Medical Review RNs typically do not earn $500,000 annually, as most nursing salaries are below that level. High earnings in nursing usually require advanced roles, specialized certifications, management positions, or work in high-paying industries or locations. Achieving such a salary may involve additional education, experience, and responsibilities beyond standard nursing roles.

What does a medical review RN do?

A Medical Review RN evaluates insurance claims, medical records, and provider documentation to determine coverage and compliance with policies. They ensure accurate assessment of medical necessity, often working with healthcare providers and insurance companies, and may require knowledge of medical coding and documentation standards.

How to make $300,000 as a nurse?

Medical Review RNs can increase their earnings by gaining specialized certifications, such as in case management or legal nurse consulting, and working in high-demand settings like telehealth or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting projects can also boost income toward $300,000 annually.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

How to make an extra 2000 a month as a nurse?

Medical Review RNs can increase their income by taking on additional freelance or per diem review assignments, working overtime, or obtaining specialized certifications to qualify for higher-paying roles. Developing expertise in specific medical areas or coding can also lead to higher-paying opportunities outside regular hours.

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.
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What states have the most Medical Review Rn jobs? States with the most job openings for Medical Review Rn jobs include:
Medical Review RN jobs near you
Infographic showing various Medical Review Rn job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $93,419 per year, or $44.9 per hour.
Utilization Review Registered Nurse

Utilization Review Registered Nurse

Ironside Human Resources

Kearney, NE

$50 - $69/hr

Full-time

Posted 17 days ago

Job description

A facility located near Lexington, Nebraska is seeking a Utilization Review Registered Nurse to join their team!

Utilization Review Registered Nurse Opportunity:

  • Full-time, permanent position
  • Schedule: Monday-Friday, 9:00AM-5:00PM
  • Collaborates with providers, departments, and community resources to ensure patient-centered care and effective communication of care plans
  • Supports utilization review, quality data collection, compliance, and accurate medical documentation while maintaining patient safety and infection control standards

Utilization Review Registered Nurse Requirements:

  • NE Registered Nurse License
  • Associate’s or Bachelor’s degree in Nursing required (Bachelor’s preferred)
  • At least two years of nursing experience
  • BLS certification required within six months of hire
  • Strong communication, documentation, and confidentiality skills with the ability to collaborate with patients, staff, insurance representatives, and regulatory agencies while following infection control protocols

The Location:

  • Located in South Central Nebraska
  • Maintains more than 100 acres of green space, public parks, trails, a skate park, aquatic center, indoor sports field house and racquets center
  • Not far from Johnson Lake which offers boating, fishing, and trails
  • Known for a welcoming small-town feel with affordable living and a strong sense of community
Interested? Contact Aidan G. | Ironsidehr.com | 469-921-0777 | aidan@ironsidehr.com

Ironside Human Resources logo

About Ironside Human Resources

Sourced by ZipRecruiter

Ironside Human Resources, based in Dallas, TX, US, is a national healthcare recruitment company that offers staffing solutions to hospitals and healthcare providers across the United States. With an official website located at ironsidehr.com, the firm specializes in direct-hire recruitment for diverse sectors, including nursing, allied health, ancillary, administrative and executive-level roles in the healthcare industry. The company was founded in 2011 and has since committed to solving the healthcare staffing shortage through their unique, cost-effective recruitment strategies. Their core commitment is defined by their professional integrity, exceptional customer service, and dedication to delivering value and effective solutions.

Industry

Recruiting and staffing services

Company size

1 - 10 Employees

Headquarters location

Dallas, TX, US

Year founded

2011

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