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Medical Review Rn Jobs in Springfield, OH (NOW HIRING)

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Medical Review Rn information

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How much do medical review rn jobs pay per hour?

As of May 28, 2026, the average hourly pay for medical review rn in Springfield, OH is $40.46, according to ZipRecruiter salary data. Most workers in this role earn between $30.96 and $48.08 per hour, depending on experience, location, and employer.

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 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 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 to become a medical review nurse?

To become a medical review nurse, one must typically earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Experience in clinical nursing and knowledge of medical coding, documentation, and healthcare regulations are also important, and some roles may require certification in case management or utilization review.
What are popular job titles related to Medical Review Rn jobs in Springfield, OH? For Medical Review Rn jobs in Springfield, OH, the most frequently searched job titles are:
What job categories do people searching Medical Review Rn jobs in Springfield, OH look for? The top searched job categories for Medical Review Rn jobs in Springfield, OH are:
What cities near Springfield, OH are hiring for Medical Review Rn jobs? Cities near Springfield, OH with the most Medical Review Rn job openings:
Registered Nurse (RN) On-Call

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago


Job description

Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.
SCHEDULE: Monday - Friday, No holiday or weekend requirements
DETAILS: This position has expected working hours from 5pm - 10pm and on-call hours from 10pm - 8:30am.
COMPANY: Kettering Home Care
HOW YOU'LL MAKE A DIFFERENCE:
As a Registered Nurse (RN) On-Call you will make a difference in the lives of our patients. Our nurses give our patients the greatest gift - the ability to spend enhanced quality time with their loved ones in their preferred environment.
As a Registered Nurse (RN) On-Call you will support a team of nurses and patients by responding to after-hours patient needs. You will have the opportunity to provide one on one patient care and work at the top of your license. You'll be part of an interdisciplinary team that focuses on providing compassionate quality care and producing positive outcomes for your patient population. Interacting with patients' families while caring for your patients and experiencing the rewarding privilege to be part of every step of their recovery journey. Home care provides context and real-world perspective about what will really help patients restore their health.
WHAT WE OFFER:
We make it easy to do your job and have competitive financial incentives. This is a salaried position. We pay mileage and have bonus opportunities. Our benefits package is also competitive in the market. We provide medical, dental, and vision insurance with flexibility for you to select what works best for you. Eligible teammates will also receive paid time off, opportunity to participate in 401k, company paid life insurance and access to a robust Employee Assistance Program.
HOW YOU'LL WORK:
You will support patients by responding to after-hours needs. You'll provide skilled nursing care in a patient's home as directed by the attending physician. You will work autonomously, so you need to be efficient in managing your time. You'll be responsible for all practices and duties within the scope of practice outlined by the state. If there are minimal to no after-hours needs during your shift, you will help with chart review or patient phone calls from your home.
MAJOR AREAS OF RESPONSIBILITY:
• Plan of Care: Observe and monitor patient conditions and perform OASIS assessments (If you don't already know this assessment, we will teach you!) to develop an individualized care plan and adjust as needs change.
• Minimize Patient Risk: Administer medication as prescribed by the physician and help decrease re-hospitalizations by prioritizing visits for high-risk patients.
• Supervision: Oversee and supervise total care of patient provided by nurse aides and LPNs
• Continuity of Care: Manage multi-disciplinary care as applicable while promoting continuity of care with appropriate admissions, transfers, and discharges.
• Family Educator/Advocate: Educate the patient and family on the disease process using teach back methods to ensure patient and family understanding.
• Policies: Complete all clinical documentation following agency protocol and Medicare/Federal guidelines. Collaborate with the interdisciplinary team and physicians to ensure optimal care is provided.
• Rules and Regulations: Understand and follow agency policies, procedures, rules, and regulations and communicate changes in schedule/availability to schedulers or supervisors.
• Operations: Attend in-service training and mandatory agency meetings.
• Chart Review: Complete chart reviews, if needed based upon after-hours needs, to support patient care and regulatory compliance.
HARD & SOFT SKILLS:
• Compassionate communicator with a positive attitude
• Patience is a virtue when working with patients, families, physicians, and coworkers
• Attention to detail is critical, as is being observant and following directions
REQUIREMENTS:
• Registered Nurse (RN) with current license in the state of employment.
• Minimum one-year experience as a Registered Nurse (RN) in an acute care setting. Home care experience preferred.
• Valid driver's license and auto insurance in your name as a driver.
• Designated workspace at home to assist with chart reviews if there are minimal to no after-hours needs.
• Capable of all physical demands.
We are proud to be part of the Alternate Solutions Health Network family.
#INDKHC9
We'll help you put your passion for patient care to work. Apply today!
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
We are an Equal Opportunity Employer.