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Remote Chart Review Nurse Jobs in Silver Spring, MD

CareFirst

Senior Data Analyst (Remote)

Baltimore, MD · Remote

$85K - $107K/yr

Expert knowledge of Risk Adjustment business processes, including diagnosis capture, HCC models, coding validation, chart review programs, risk score generation, prospective and retrospective ...

QTC

Registered Nurse

Mclean, VA · On-site +1

Provide support with chart reviews/documentation, scheduling and confirming appointments, answering ... State nursing license valid in Virginia * Advanced Cardiac Life Support (ACLS) and Basic Life ...

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Remote Chart Review Nurse information

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How much do remote chart review nurse jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for remote chart review nurse in Silver Spring, MD is $39.92, according to ZipRecruiter salary data. Most workers in this role earn between $30.58 and $44.71 per hour, depending on experience, location, and employer.

What is a remote chart review nurse?

A Remote Chart Review Nurse is a licensed nurse who reviews medical records remotely to ensure accuracy, compliance, and quality of care. They analyze patient charts for coding accuracy, insurance requirements, risk adjustment, or legal compliance. This role is often found in insurance companies, healthcare organizations, and legal firms. It requires strong attention to detail, clinical knowledge, and proficiency in electronic health records (EHR) systems.

What does a remote chart review nurse do?

A Remote Chart Review Nurse spends most of their day independently reviewing patient medical records, extracting relevant clinical data, and ensuring accuracy and compliance with guidelines. This role often includes collaborating with other nurses, physicians, and quality assurance teams via virtual meetings or secure messaging platforms. Tasks can range from auditing charts for quality measures to preparing summaries or reports that support clinical or insurance decisions. While most of the work is self-directed, there may be deadlines to meet and occasional team meetings or training sessions to attend. This flexible structure allows you to work from home while still playing a key role in improving patient care quality.

What skills and qualifications are needed to be a remote chart review nurse?

To thrive as a Remote Chart Review Nurse, you need an active RN license, strong clinical knowledge, and proficient medical record analysis skills. Familiarity with electronic health record (EHR) systems, HIPAA compliance, and URAC or NCQA standards is typically required, and experience with chart review software is a plus. Excellent attention to detail, time management, and strong written communication are key soft skills in this remote position. These abilities are crucial for ensuring accurate, timely reviews of patient charts, maintaining patient privacy, and supporting healthcare decision-making from a remote environment.

What are popular job titles related to Remote Chart Review Nurse jobs in Silver Spring, MD?

For Remote Chart Review Nurse jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Remote Chart Review Nurse jobs in Silver Spring, MD look for?

The top searched job categories for Remote Chart Review Nurse jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Remote Chart Review Nurse jobs?

Cities near Silver Spring, MD with the most Remote Chart Review Nurse job openings:

Remote Chart Review Nurse jobs near you
Infographic showing various Remote Chart Review Nurse job openings in Silver Spring, MD as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $83,034 per year, or $39.9 per hour.

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 18 days ago

Job description

Utilization Management Specialist (UM / Utilization Review Nurse) — Remote

Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: Mon–Fri, 8:00am–5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00am–9:00am ET Pay (W2): USD 51.00/H

Job overview

In this role, you’ll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. You’ll work fully remote and leverage MCG, medical policy, and regulatory guidelines while collaborating with Medical Directors and internal teams to support timely, accurate authorization decisions.

What you’ll do

  • Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health).
  • Make medical necessity / appropriateness determinations and support prior authorizations.
  • Use clinical criteria and policy resources daily (including MCG / Milliman Care Guidelines).
  • Review clinical documentation, benefits, and mandates to ensure services align with coverage and guidelines.
  • Research diagnoses/treatments and high-cost services; summarize findings and escalate complex cases to Medical Directors as needed.
  • Collaborate with internal partners and providers to support benefit application and appropriate levels/settings of care.
  • Maintain accurate documentation and protect PHI while managing a busy caseload.

Required qualifications

  • Active RN or LPN license (RN preferred) — Maryland compact/eligibility required
  • 5+ years clinical nursing experience
  • 2+ years care management / utilization management experience
  • MCG experience (required)
  • Experience supporting Commercial/FEP/Medicare lines of business and applying medical policy/regulatory standards
  • Strong critical thinking, written communication, and ability to work independently in a remote setting
  • Comfortable with web-based tools + Microsoft Office (Word/Excel/PowerPoint)
  • Guiding Care and FACETS (required)

Nice to have

  • Critical Care or ER clinical background
  • Experience with LCD/NCD, Medicare guidelines, ASAM, or other authorization criteria sets

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-1 #LI-AJ1 Ref: #851-Rockville-S1

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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US

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