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Remote Rn Chart Review Jobs in Towson, MD (NOW HIRING)

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

Licenses/Certifications Upon Hire Required: * RN - Registered Nurse - State Licensure And/or ... Review, Disease Management or other direct patient care experience. Bilingual - fluent in Spanish ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

... RN - Registered Nurse in MD, VA or Washington, DC. Experience: 5 years' clinically related experience working in Discharge Coordination and/or Utilization Review. Preferred Qualifications:

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

... Review, Disease Management or other direct patient care experience. Preferred Qualifications: * Bachelor's degree in nursing * CCM/ACM or other RN Board Certified certification in case management.

DataAnnotation

Registered Nurse

Baltimore, MD · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...

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All JobsRemote Rn Chart Review JobsRemote Rn Chart Review Jobs in Towson, MD

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.
More about Remote Rn Chart Review jobs
What job categories do people searching Remote Rn Chart Review jobs in Towson, MD look for? The top searched job categories for Remote Rn Chart Review jobs in Towson, MD are:
What cities near Towson, MD are hiring for Remote Rn Chart Review jobs? Cities near Towson, MD with the most Remote Rn Chart Review job openings:
Remote Rn Chart Review jobs near you
Infographic showing various Remote Rn Chart Review job openings in Towson, MD as of June 2026, with employment types broken down into 3% As Needed, 61% Full Time, 20% Part Time, 3% Temporary, and 13% Contract. Highlights an 100% Remote job distribution.

Clinical Reviewer (Part-time)

Neil Hoosier & Associates, Inc.

Owings Mills, MD • On-site, Remote

$40 - $45/hr

Part-time

Posted 11 days ago

Job description

Pay Range: $40 - $45 per hour based on experience
Work Hours: 20 hours per week (Mon - Fri)
Location: Remote
Summary:
The Clinical Reviewer is responsible for conducting clinical reviews of submitted prior authorization (PA) requests and pre-payment requests submitted to Fee-For-Service Medicare by Providers and/or Suppliers. The reviewer verifies that each request includes accurate, complete clinical documentation and meets all applicable Medicare coverage, coding, and payment rules, including National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). This role ensures that determinations are evidence-based, compliant, and aligned with the CMS requirements.
Responsibilities and Duties:
  • Review submitted prior authorization requests and/or pre-payment requests to determine whether required documentation is complete, accurate, and compliant with Medicare criteria.
  • Evaluate medical necessity based on relevant NCDs, LCDs, and Local Coverage Articles as required for each item and/or service assessing clinical evidence provided.
  • Provide clinical justification for affirmation or non-affirmation of accuracy decision
  • Ensure all determinations align with Medicare requirements and CMS model rules
  • Maintain thorough, organized documentation of clinical assessments, rationale, and determinations.
  • Support quality reviews to ensure consistency and accuracy across determinations.
  • Assist with writing review protocols, procedures, workflows, etc
  • Attend required meetings and workgroups as needed to perform independent case reviews (e.g., procedural changes, sharing trends, reviewing information on specific case files, and discussing issues or questions)
  • Meet productivity and quality assurance standards
  • Work in Project Manager to determine reviewer workload, tasking, and priorities

Qualifications:
  • Licensed clinician (e.g., MD/DO, PA, NP, RN)
  • At least 5 years of professional healthcare experience
  • Working knowledge and understanding of Medicare coverage guidelines and clinical expertise to evaluate the medical necessity determination
  • Medical Coding Certification (ICD-9-CM, ICD-10-CM, CPT-4 and HCPCS) preferred
  • Ability to interpret clinical records, imaging, diagnostic tests, and practitioner notes.
  • Familiarity with CMS prior authorization programs, MAC processes, or pre-payment medical review, preferred
  • Excellent clinical judgement and critical thinking.
  • Strong written and oral communication skills for documenting and communicating determinations.
  • Ability to work in a structured, time-sensitive environment.
  • High attention to detail and accuracy.
  • Proficiency with Microsoft Office Suite such as Outlook, Word, Teams, and Excel, and SharePoint
  • Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program
  • Must have no conflict of interest (COI) as defined in Section 1154(b)(1) of the Social Security Act (SSA)

NHA is a state and federal government contractor; all employees must be legally authorized to work in the United States. NHA does not provide sponsorship at this time.
NHA is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment based on merit, without regard to race, color, religion, sex, sexual orientation, national origin, veteran status, disability or any other basis protected by law.

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