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

IntelyCare

Registered Nurse RN

Springfield, OH

RNs play a key role in providing high-quality care to our residents, overseeing nursing staff, and ensuring that our residents' medical and personal needs are met in a supportive and comfortable ...

Montgomery County, OH

Registered Nurse (RN)

Dayton, OH · On-site

$37.53 - $50.67/hr

Review and insure correlation of physician order, pharmacy printout and MAR/TAR. Maintain ... of all residents' medical care and treatment records; ensure privacy of protected health ...

Argon Agency

Registered Nurse

Vandalia, OH

$40 - $45/hr

Conduct initial and ongoing medical assessments to identify health concerns and coordinate ... Your application will be reviewed by our hiring team. If we identify that you will be a possible ...

Argon Agency

Registered Nurse

Vandalia, OH · On-site

$40 - $45/hr

Conduct initial and ongoing medical assessments to identify health concerns and coordinate ... Your application will be reviewed by our hiring team. If we identify that you will be a possible ...

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How much do medical review rn jobs pay per hour?

As of May 29, 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.
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What cities near Springfield, OH are hiring for Medical Review Rn jobs? Cities near Springfield, OH with the most Medical Review Rn job openings:
Medical Review Rn jobs near you
Registered Nurse (RN)

Registered Nurse (RN)

Court House Manor

Washington Court House, OH

Other

Posted 2 days ago

Job description

Position Summary:
A Registered Nurse administers resident care under the supervision of the Director of Nursing and/or a physician to maintain the highest level of resident care.
Position Responsibilities for a Nurse:
* Must function within scope of practice according to the State Board of Nursing
* Administers medication and treatments as prescribed by physician
* Must follow HCF Policy and Procedures
* Must meet job related competencies as outlined in the Skills Competency Manual
for Registered Nurse (RN)
* Supervises, evaluates and may suspend personnel according to HCF policy
* Accurately complete documentation of care given
* Refers to, assists in developing, and follows resident’s care plan
* Observes, assesses and reports any abnormal findings, such as, injuries, incidents, skin issues, complaints, suspected abuse/neglect/misappropriation, and any unsafe conditions as well as any significant change in condition
* Follows appropriate Infection Control and Safety Practices
Knowledge, Skills and Abilities: Graduation from an accredited school of nursing. Current license as a Registered Nurse with the State Board of Nursing. CPR certification recommended.
Benefits for a RN:
* Promotion opportunities
* Flexibility
* Education/Learning
* Competitive benefit package
What we look for in a Registered Nurse:
Experience – If you’ve had a job or experience in a position with similar goals and responsibilities, we’d love to connect with you.
Skills – We’re looking for individuals that are compassionate, team players, social, trustworthy and service-minded.
Characteristics – We’re looking for individuals that are self-motivated, dependable, ethical, and ready to jump in and provide outstanding care and customer service to our residents.
The Company
Our Core Values, better known as We Care is that each and every employee in the organization is held to standards of Wholeheartedness, Excellence, Collaboration, Accountability, Respect, and being Ethical. Whether you work for HCF or become a resident of HCF, we can promise you one thing; we will treat you like family!
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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