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Remote Rn Chart Review Jobs in Sumter, SC (NOW HIRING)

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

NCLEX Tutor

Columbia, SC · Remote

$40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

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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.

What are popular job titles related to Remote Rn Chart Review jobs in Sumter, SC? For Remote Rn Chart Review jobs in Sumter, SC, the most frequently searched job titles are:
What job categories do people searching Remote Rn Chart Review jobs in Sumter, SC look for? The top searched job categories for Remote Rn Chart Review jobs in Sumter, SC are:
What cities near Sumter, SC are hiring for Remote Rn Chart Review jobs? Cities near Sumter, SC with the most Remote Rn Chart Review job openings:
Infographic showing various Remote Rn Chart Review job openings in Sumter, SC as of May 2026, with employment types broken down into 71% Full Time, and 29% Contract. Highlights an 100% Remote job distribution.
Quality Medical Auditor - Inpatient Coding

Quality Medical Auditor - Inpatient Coding

BlueCross BlueShield of South Carolina

Columbia, SC • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


BlueCross BlueShield of South Carolina rating

7.3

Company rating: 7.3 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

207th of 259 rated insurance


Job description

Summary
Performs validation reviews of Diagnosis Related Groups (DRG), Ambulatory Procedure Codes (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Description
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose: Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department.
Location: This is a remote position, Monday - Friday from 8:30am - 5pm.
What You'll Do:
  • Determines methodology to identify cases for validation review. Conducts validation reviews/coordinates rates adjustments with appropriate claims area. Creates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates.
  • Manages records retrieval, release, HIPAA compliance, and all aspects of document management.
  • Serves as expert resource on methodology and procedures for medical records and coding issues.

To Qualify for This Position, You'll Need the Following:
  • Required Education: Associates in a job-related field.
  • Degree Equivalency: 2 years job related work experience.
  • Required Work Experience: 3 years medical record management to include coding and validation review experience.
  • Skills and Abilities: Excellent verbal and written communication, organizational, customer service, and analytical or critical thinking skills. Good judgment. Ability to handle confidential or sensitive information with discretion. Extensive medical records and coding knowledge. Working knowledge of contract evaluations, claims processing and adjudication practices.
  • Required Licenses and Certificates: Registered health information administrator (RHIA) OR Registered health information technician (RHIT) OR Certified Professional Coder (CPC) OR Certified Inpatient Coder (CIC) or Certified Professional Medical Auditor (CPMA) OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multi-state unrestricted RN license as defined by Nurse Licensure Compact (NLC).

Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.

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BlueCross BlueShield of South Carolina logo

About BlueCross BlueShield of South Carolina

Sourced by ZipRecruiter

BlueCross BlueShield of South Carolina, headquartered in Columbia, SC, USA, is a major stakeholder in the country's healthcare sector. The company holds the distinction of being one of the largest health insurers in South Carolina. As an independent licensee of the BlueCross BlueShield Association, it offers an extensive range of health insurance products and services, focusing not just on medical coverage, but also on dental, vision, and other supplementary health options. The company was founded in 1946 and has since established itself as a trusted leader in the health sector, committed to affordability, accessibility, and customer service. Their mission is to ensure that all South Carolinians have access to high-quality healthcare and exemplify the core values of accountability, transparency, and commitment to customer satisfaction.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Columbia, SC, US

Year founded

1946

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