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Medical Review Rn Jobs in Dallas, TX (NOW HIRING)

TNAA TotalMed RN

Travel Nurse RN - Med Surg

Dallas, TX · On-site

$2.0K - $2.6K/wk

  • Medical

  • Dental

  • Vision

  • Retirement

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

VITAS Healthcare

Registered Nurse (RN)

Dallas, TX · On-site

... medical, psychosocial, emotional and spiritual needs of hospice patients and families facing ... Manager reviews * Registered Nurse, RN, responsible for attending orientation and regularly ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES: * This ...

TNAA TotalMed RN

Travel Med Surg RN

Dallas, TX · On-site

$2.0K - $2.6K/wk

  • Medical

  • Dental

  • Vision

  • Retirement

TNAA TotalMed RN is seeking a travel nurse RN Med Surg for a travel nursing job in Dallas, Texas. & Requirements * Specialty: Med Surg * Discipline: RN * Start Date: 09/21/2026 * Duration: 13 weeks ...

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All JobsMedical Review Rn JobsMedical Review Rn Jobs in Dallas, TX

Medical Review Rn information

See Dallas, TX salary details

$23

$44

$69

How much do medical review rn jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for medical review rn in Dallas, TX is $44.43, according to ZipRecruiter salary data. Most workers in this role earn between $33.99 and $52.79 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.

What cities near Dallas, TX are hiring for Medical Review Rn jobs?

Cities near Dallas, TX with the most Medical Review Rn job openings:

Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Dallas, TX as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $92,414 per year, or $44.4 per hour.

Medical Necessity Review Registered Nurse

TEXAS INSTITUTE FOR SURGERY

Dallas, TX • On-site

Full-time

Re-posted 11 days ago

Job description

The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review. 

This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify, mitigate, and reduce denial risk. The role also collaborates closely with Case Management to align patient status, authorization, and progression of care with payer requirements.

Essential Duties and Responsibilities:

  1. Conduct admission and concurrent medical necessity reviews using established criteria and ensure appropriate patient status assignment.
  2. Manage payer authorizations, reviews, and communications to support reimbursement and regulatory compliance.
  3. Identify and mitigate denial risks through proactive review of medical necessity, documentation, and authorization requirements.
  4. Collaborate with physicians, case management, and revenue cycle teams to support accurate clinical documentation, patient progression, and denial prevention.
  5. Monitor census, length of stay, high-risk cases, and reimbursement barriers, escalating issues as needed.
  6. Maintain complete utilization review documentation and support audits, quality initiatives, and process improvement activities.
  • Education & Training:
    • Associate's degree in nursing required
    • Bachelor's degree in nursing preferred
  • Experience:
    • 3+ years of acute care experience required
    • Experience in utilization review and/or case management in an acute care hospital setting required
  • Licensure/Certification/Registration:
    • Current RN license in the state of Texas required
    • BLS required
    • Must possess and maintain a valid driver’s license as employees may occasionally be required to operate a company vehicle. Reasonable accommodations may be provided as required by law.
  • Key Skills:
    • Comprehensive knowledge of CMS regulations, utilization management standards, and commercial payer requirements.
    • Strong communication, collaboration, critical thinking, and analytical skills.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable law.

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