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How much do medicare chart reviewer jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medicare chart reviewer in the United States is $29.88, according to ZipRecruiter salary data. Most workers in this role earn between $22.60 and $36.54 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medicare Chart Reviewer?

To thrive as a Medicare Chart Reviewer, you need a solid background in medical coding, clinical documentation, and a comprehensive understanding of Medicare regulations, often supported by certifications like CPC or CCS. Familiarity with Electronic Health Record (EHR) systems, chart abstraction tools, and auditing software is commonly required. Strong attention to detail, analytical thinking, and effective communication are key soft skills in this role. These capabilities ensure accurate chart reviews, regulatory compliance, and effective collaboration with healthcare providers and administrative teams.

What is a Medicare Chart Reviewer?

A Medicare Chart Reviewer is responsible for reviewing medical records to ensure accuracy, compliance with Medicare guidelines, and proper documentation of patient care. They analyze charts to identify coding errors, missing information, or inconsistencies that could impact billing and reimbursement. This role requires knowledge of medical terminology, Medicare regulations, and coding standards such as ICD-10 and CPT. Medicare Chart Reviewers often work for healthcare providers, insurance companies, or third-party review organizations to support audits and compliance efforts.

What are some typical challenges a Medicare Chart Reviewer might face in daily work?

Medicare Chart Reviewers often encounter challenges such as interpreting complex medical records, staying current with frequently changing Medicare guidelines, and ensuring that all documentation is complete and compliant. Balancing efficiency with accuracy is critical, as even small errors can impact billing or reimbursement. Additionally, chart reviewers may need to collaborate with clinicians to clarify inconsistencies or request additional information, which requires professional communication skills. Successfully navigating these challenges helps ensure proper coding and reduces the risk of regulatory penalties for healthcare organizations.

How much do Medicare chart reviewers make in the US?

Medicare chart reviewers in the US typically earn between $40,000 and $70,000 annually, depending on experience, location, and employer. The role often requires attention to detail, familiarity with medical records, and certification in medical coding or billing.

How to become a Medicare Chart Reviewer?

To become a Medicare Chart Reviewer, candidates typically need a background in healthcare, such as nursing, medical coding, or health information management. Relevant skills include attention to detail, knowledge of medical records and coding systems, and familiarity with Medicare policies; some positions may require certification or training in medical coding or health information technology.
More about Medicare Chart Reviewer jobs
What are the most commonly searched types of Medicare Chart Reviewer jobs? The most popular types of Medicare Chart Reviewer jobs are:
What states have the most Medicare Chart Reviewer jobs? States with the most job openings for Medicare Chart Reviewer jobs include:
What job categories do people searching Medicare Chart Reviewer jobs look for? The top searched job categories for Medicare Chart Reviewer jobs are:
Medicare Chart Reviewer jobs near you
Infographic showing various Medicare Chart Reviewer job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $62,159 per year, or $29.9 per hour.

Nurse Reviewer - Tampa, FL

Healthcare Quality Strategies, Inc.

Tampa, FL • Remote

$40/hr

Part-time

Medical, Dental, Vision, Life, Retirement

Re-posted 26 days ago

Job description

Nurse Reviewer
PT (20-30 hours week) – Remote Work Environment
Non-Exempt: $40.00 hour
Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy reviews for Medicaid claims. This involves meticulous examination of claims and medical records to ensure compliance with established guidelines and regulations. The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely.
Essential Duties and Responsibilities:
  • Conduct comprehensive medical record reviews to assess medical necessity and compliance with established standards of care and applicable policies
  • Manage end-to-end case screening processes, ensuring all activities are completed within established deadlines
  • Document evidence-based criteria applicable to specific contract requirements
  • Record and report screening results, including relevant referral questions, into a centralized database
  • Evaluate medical claims against industry standards, utilizing research of relevant ICD-10, CPT, and HCPCS codes to determine medical necessity
  • Maintain expert knowledge of evolving multi-state Medicaid policies and vendor expectations
  • Participate in ongoing training and consistently meet or exceed productivity and quality assurance standards
Knowledge, Experience, Skills and Education:
  • Medical terminology, ICD-10, CPT and HCPCS
  • Clinical criteria (InterQual and MCG)
  • Utilization/Medical record review and chart abstraction
  • Current standards of medical practice
  • Comply with HIPAA/HITECH laws and regulations
Experience in:
  • At least three- five years performing medical record review and/or abstraction (Utilization Review experience preferred)
  • Experience performing medical record review, audit for federal or state contracts
  • Knowledge and experience of Medicare and Medicaid policy
  • Proficiency with Microsoft Office (Word, Excel, and Outlook)
  • Proficiency with Adobe PDF files and features
  • Generating accurate, timely, and understandable correspondence
  • Current experience (within the last 3 years) in the application of clinical screening criteria (InterQual and MCG)
Skills Requirements include:
  • Professional interpersonal skills; ability to interact with providers, physicians and peers
  • Solid analytical, assessment and documentation skills
  • Effective written and verbal communication, both internally and externally
  • Strong attention to detail
  • Strong attention to deadlines
  • Organizational skills including effective time management, priority setting and process improvement
  • Ability to work independently and as a member of a team
  • Adapt to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations
Educational Background:
  • BSN with active RN licensure in good standing
Physical Demands:
Remote Work, Prolonged Sitting, Screen Exposure
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.
Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This position qualifies for the following Company benefits: Medical/Dental/Vision, FSA and HSA, group life/AD amp;D, voluntary life/AD amp;D, 401k
For immediate consideration, please apply via the HQSI Careers Page at: www.hqsi.org gt; Careers gt; Current Employment Opportunities
EOE: Minorities/Females/Disabled/Veterans
Healthcare Quality Strategies, Inc. is Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug Free Workplace
Healthcare Quality Strategies, Inc. is an E-Verify Employer

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