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Remote Rn Chart Review Jobs in Brea, CA (NOW HIRING)

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...

Molina Healthcare

Care Review Clinician (RN)

Long Beach, CA · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

Molina Healthcare

Care Review Clinician (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...

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Remote Rn Chart Review information

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 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.

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.

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.

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Remote Rn Chart Review jobs near you
Care Review Clinician - Utilization Review (KY RN license- REMOTE)

Care Review Clinician - Utilization Review (KY RN license- REMOTE)

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 26 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

144th of 259 rated insurance

Job description

JOB DESCRIPTION
 Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. 
Essential Job Duties 
Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. 
Analyzes clinical service requests from members or providers against evidence based clinical guidelines. 
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. 
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. 
Processes requests within required timelines. 
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. 
Requests additional information from members or providers as needed. 
Makes appropriate referrals to other clinical programs. 
Collaborates with multidisciplinary teams to promote the Molina care model. 
Adheres to utilization management (UM) policies and procedures. 
Required Qualifications 
At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. 
Registered Nurse (RN). License must be active and unrestricted in state of practice. 
Ability to prioritize and manage multiple deadlines. 
Excellent organizational, problem-solving and critical-thinking skills. 
Strong written and verbal communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 
Preferred Qualifications 
Certified Professional in Healthcare Management (CPHM). 


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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