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Medical Review Rn Jobs in Georgia (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 ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

You will perform frequent case reviews, check medical records and speak with care providers ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Elevance Health

Nurse Reviewer 1

Atlanta, GA · On-site

Conducts initial medical necessity review of exception preauthorization requests for services ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Travel Nurses, Inc.

Travel Nurse RN - Med Surg

Albany, GA · On-site

$1.8K - $2.4K/wk

Travel Nurses, Inc. is seeking a travel nurse RN Med Surg for a travel nursing job in Albany ... Before every contract, clinicians complete an engagement letter review that outlines pay packages ...

Travel Nurses, Inc.

Travel Nurse RN - Med Surg

Albany, GA · On-site

$1.8K - $2.4K/wk

Travel Nurses, Inc. is seeking a travel nurse RN Med Surg for a travel nursing job in Albany ... Before every contract, clinicians complete an engagement letter review that outlines pay packages ...

UHS

Utilization Review Clinician

Augusta, GA

Review clinical content of medical records, participate in treatment team meetings, and collaborate ... CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.

UHS

Utilization Review Clinician

Augusta, GA

Review clinical content of medical records, participate in treatment team meetings, and collaborate ... CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.

Elevance Health

Nurse Reviewer 1

Atlanta, GA

Conducts initial medical necessity review of exception preauthorization requests for services ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and ... (RN, APRN, LPC, LMSW, LCSW, etc) EXPERIENCE: A minimum of five (5) years direct clinical ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and ... (RN, APRN, LPC, LMSW, LCSW, etc) EXPERIENCE: A minimum of five (5) years direct clinical ...

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Medical Review Rn information

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.
What cities in Georgia are hiring for Medical Review Rn jobs? Cities in Georgia with the most Medical Review Rn job openings:
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Georgia as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, 1% Temporary, and 6% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.
Utilization Review RN

Utilization Review RN

Lancesoft INC

Atlanta, GA • On-site

$3.0K - $3.1K/wk

Contractor

Posted 5 days ago

Job description

Job title: Utilization Review

Shift: 09:30 AM to 08:00 PM

13 weeks contract

Description:

  • 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 SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.
LanceSoft logo

About LanceSoft

Sourced by ZipRecruiter

Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we're 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Herndon, VA, US

Year founded

2000

Social media

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