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Medical Review Rn Jobs in Baltimore, MD (NOW HIRING)

TotalMed RN

Travel Neuro Med-Surg Tele RN

Baltimore, MD · On-site

$2.0K - $2.6K/wk

TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Baltimore, Maryland. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 09/28 ...

TotalMed RN

Travel Med Surg/Telemetry RN

Towson, MD · On-site

$1.9K - $2.6K/wk

TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Towson, Maryland. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Duration: 9 weeks * 36 ...

TotalMed RN

Travel Nurse RN - Med Surg

Baltimore, MD · On-site

TotalMed RN is seeking a travel nurse RN Med Surg for a travel nursing job in Baltimore, Maryland. & Requirements * Specialty: Med Surg * Discipline: RN * Duration: 13 weeks * 36 hours per week

TotalMed RN

Travel Nurse RN - Med Surg

Baltimore, MD · On-site

TotalMed RN is seeking a travel nurse RN Med Surg for a travel nursing job in Baltimore, Maryland. & Requirements * Specialty: Med Surg * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks ...

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All JobsMedical Review Rn JobsMedical Review Rn Jobs in Baltimore, MD

Medical Review Rn information

See Baltimore, MD salary details

$23

$44

$69

How much do medical review rn jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for medical review rn in Baltimore, MD is $44.63, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $53.03 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.

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.

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.

How to become a medical review RN?

To become a medical review RN, you need to earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Additionally, gaining experience in clinical settings and obtaining certifications such as Certified Professional Coder (CPC) or specialized training in medical review can enhance qualifications for this role.
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Baltimore, MD as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, and 5% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $92,825 per year, or $44.6 per hour.

Medical Reviewer, Register Nurse Coder

Millersville, MD • On-site, Remote

J29 Inc.
Business Management Consulting • 1 - 10 employees
Learn more about J29 Inc.external

$18.25 - $24.25/hr

Full-time

Posted 19 days ago

Job description

Medical Reviewer, RN Coder - Temporary Position
Location: Remote
*This role is a temporary position and that employment is expected to be for a limited duration (approx. 3-6 months)
About J29
J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as an employee-centered healthcare management consulting company. Our team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinical expertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels.
J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow.
Key Responsibilities
RVC Reviewers perform both automated and complex reviews of Medicare Fee-for-Service (FFS) claims-including Part A/B, DMEPOS, and Home Health/Hospice-to assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors (RACs). They apply Medicare policies and guidelines, ensuring claims are evaluated according to National and Local Coverage Determinations and CMS rules, and document clear, accurate findings for each claim.
Reviewers participate in dispute resolution by re-examining claims and providing supporting documentation, support quality assurance through audits and ongoing training, and maintain compliance with CMS security and privacy standards. They also collaborate closely with key personnel to ensure consistency, accuracy, and continuous process improvement in all review activities.
Qualifications
  • 5+ years of direct medical coding or medical billing experience, specifically in a healthcare environment.
  • 3+ years working in a productivity-based claims or case working environment, out of a queued case management system.
  • 3+ years working remotely with various technology systems. Ideally, candidate will have 3+ years of Medicare Fee For Service (FFS) experience in a medical coding role or program.
  • Active Medical Coding Certification (CPC, CCS or equivalent) required
  • Experience with low-code, no-code case management systems as an end-user is preferred but not required.

Education/Certification
  • Active license as a Registered Nurse, in good standing, in the United States (as verified by Nurses). Verified regularly.

J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.
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About J29

Sourced by ZipRecruiter

Industry

Business management consulting

Company size

1 - 10 Employees

Headquarters location

Millersville, MD, US

Year founded

2017

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