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Remote Rn Chart Review Jobs in Oregon (NOW HIRING)

firsthand Health

Remote Triage Nurse

Eugene, OR · Remote

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is ...

firsthand Health

Remote Triage Nurse

Eugene, OR · On-site +1

$80K/yr

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support ... Such requests will be subject to review and approval by the Company, and exemptions will be granted ...

Personify Health

Lead Utilization Review-RN

... UM RN Reviewer / Team Lead I) * Serve as a visible first-line leader for assigned UM staff by ... Remote leadership effectiveness: dependable attendance, organization, and ability to troubleshoot ...

Personify Health

Lead Utilization Review-RN

... UM RN Reviewer / Team Lead I) * Serve as a visible first-line leader for assigned UM staff by ... Remote leadership effectiveness: dependable attendance, organization, and ability to troubleshoot ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Corvel

Clinical Review QC Auditor

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Experience in the OR, ICU, or ER as an RN highly preferred * Required minimum of 2 year of recent ...

CERiS

Clinical Review QC Auditor

$68K - $104K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Review medical records to ... Experience in the OR, ICU, or ER as an RN highly preferred * Required minimum of 2 year of recent ...

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Remote Rn Chart Review information

What are the key skills and qualifications needed to thrive as a Remote RN Chart Review, and why are they important?

To thrive as a Remote RN Chart Review, you need a thorough understanding of clinical guidelines, patient care documentation, and medical coding, supported by an active RN license and experience in clinical settings. Proficiency with electronic medical records (EMR) systems, chart auditing tools, and sometimes certification in coding (like CPC or CCS) is often required. Strong attention to detail, analytical thinking, and effective written communication are vital soft skills for accurately reviewing and summarizing medical records. These skills and qualifications ensure the accuracy and compliance of patient documentation, which is critical for quality assurance and regulatory standards in healthcare.

How Can I Get a Remote Job as a Chart Review RN?

The qualifications to get a remote job as a chart review nurse include a nursing degree, a nursing license, and experience using medical records and coding systems. You can start out on this career path by becoming a registered nurse (RN) or a practical nurse (LPN). This process involves earning an associate or bachelor’s degree in nursing and passing the NCLEX-RN licensing exam. It’s essential to have strong communication and analytical skills, attention to detail, and a reliable computer with internet access to work from home. Earning certification from the American Association of Medical Audit Specialists or the American Academy of Professional Coders is a plus.

What is a Remote RN Chart Review?

A Remote RN Chart Review is a nursing role where registered nurses review and analyze patient medical records from a remote location, rather than working on-site at a hospital or clinic. These nurses assess documentation for accuracy, completeness, and compliance with healthcare regulations. Their work helps ensure quality care, proper coding for billing, and adherence to legal standards. Remote chart reviewers often work for insurance companies, healthcare organizations, or third-party vendors, using secure digital platforms to access and evaluate patient charts.

What is the difference between Remote Rn Chart Review vs Remote LPN Chart Review?

AspectRemote Rn Chart ReviewRemote LPN Chart Review
CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentHealthcare facilities, insurance companies, telehealthSimilar settings, often with more limited scope
Job ResponsibilitiesComprehensive chart review, complex case analysisBasic chart review, documentation verification

Remote Rn Chart Review and Remote LPN Chart Review both involve reviewing patient records remotely. However, RNs typically handle more complex cases requiring a broader scope of practice and higher credentials, while LPNs focus on more routine documentation tasks. Both roles are essential in healthcare documentation and insurance claims, but RNs generally have more advanced responsibilities and qualifications.

What are some common challenges faced by Remote RN Chart Review nurses, and how can they be overcome?

Remote RN Chart Review nurses often encounter challenges such as managing large volumes of medical records, ensuring data accuracy, and maintaining effective communication with healthcare teams from a distance. Staying organized and utilizing electronic health record (EHR) systems efficiently can help manage workload and prevent errors. Proactive communication through secure messaging or virtual meetings is crucial for clarifying documentation and collaborating with physicians and other staff. Additionally, ongoing training in compliance and evolving chart review standards can help nurses stay current and confident in their role.
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Remote Rn Chart Review jobs near you
Remote RN - Medical Claims Reviewer

Remote RN - Medical Claims Reviewer

Broadway Ventures

OR • Remote

Other

Re-posted 27 days ago

Job description

Job Type: Full-time (40 hours/week)
Schedule: Monday-Friday, 8:00 AM - 5:00 PM

Max Salary: W-2 ($65,000/$31.25)

Location: Remote (U.S. - Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience plus at least two years in one of the following:
    • Home Health
    • Utilization/Medical Review
    • Quality Assurance
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
Preferred Qualifications
  • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
  • Proficiency in using multiple screens and software programs simultaneously.

If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!

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