ZipRecruiter

Log In

2

Remote Rn Chart Review Jobs in York, PA (NOW HIRING)

Varsity Tutors

NCLEX-RN Tutor

Harrisburg, PA · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Capital Blue Cross

RN Care Manager

Harrisburg, PA · On-site +1

$28.25/hr

The Care Manager uses a collaborative process to assess Member needs, review options for services ... Registered Nurse with active licensure in home state; additional state's licensure as needed ...

Varsity Tutors

NCLEX-PN Tutor

Harrisburg, PA · Remote

$18 - $40/hr

... 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 ...

next page

Showing results 1-20

All JobsRn Chart Review JobsRemote Rn Chart Review JobsRemote Rn Chart Review Jobs in York, PA

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 are popular job titles related to Remote Rn Chart Review jobs in York, PA? For Remote Rn Chart Review jobs in York, PA, the most frequently searched job titles are:
What job categories do people searching Remote Rn Chart Review jobs in York, PA look for? The top searched job categories for Remote Rn Chart Review jobs in York, PA are:
What cities near York, PA are hiring for Remote Rn Chart Review jobs? Cities near York, PA 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 York, PA as of July 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% Remote job distribution.
Remote/Hybrid Registered Nurse (RN) - Advocacy & Program Integrity (Medical Assistance- Med Surg Hos

Remote/Hybrid Registered Nurse (RN) - Advocacy & Program Integrity (Medical Assistance- Med Surg Hos

The CKHobbie Group

Harrisburg, PA • On-site, Remote

$40 - $42/hr

Full-time

PTO

Posted 20 days ago

Job description


Are you a registered nurse ready to take your career in an exciting newdirection-one where your expertise truly makes a difference? JoinPennsylvania's premier Quality Improvement Organization and step into adynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion the needs of vulnerable populations,safeguard the quality of care, and influence healthcare outcomes on ameaningful scale. Enjoy the freedom of working from home, theflexibility and autonomy to manage your workday, and the opportunity forcontinuous professional growth-all while being part of a passionate,mission-driven team dedicated to improving healthcare across theCommonwealth.
Are you a registered nurse ready to take your career in an excitingnew direction-one where your expertise creates real, lasting impact?Join Pennsylvania's premier Quality Improvement Organization and play a vital role in protecting healthcare quality, advocating forvulnerable populations, and ensuring the integrity of criticalhealthcare programs.
In this rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity initiatives, and advocate for beneficiaries across theCommonwealth. You'll enjoy the flexibility of working from home, theautonomy to manage your work, and meaningful opportunities forprofessional growth-all while contributing to a mission that trulymatters.
What You'll Do
  • Conduct clinical reviews and ensure quality, appropriateness, and compliance with healthcare standards
  • Support program integrity efforts by identifying trends, risks, and opportunities for improvement
  • Advocate for beneficiaries, with a strong focus on protecting and improving care for vulnerable populations
  • Apply nursing judgment to analyze medical records, documentation, and billing data
  • Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices
  • Contribute to quality improvement initiatives that strengthen healthcare delivery across Pennsylvania

What We're Looking For
  • Active, unrestricted Registered Nurse (RN) license
  • Strong clinical background with the ability to apply nursing judgment analytically
  • Interest in advocacy, quality improvement, and healthcare program integrity
  • Excellent written and verbal communication skills
  • Ability to work independently while managing multiple priorities
  • Comfort with technology and electronic medical records

Experience in utilization review, case management, quality improvement, compliance, or claims review is a plus-but not required.
Why Join Us
  • Mission-driven work with Pennsylvania's leading Quality Improvement Organization
  • Make a real impact on healthcare quality and outcomes for vulnerable populations
  • Remote work - enjoy the convenience and balance of working from home
  • Autonomy and flexibility in how you manage your workday
  • Advocacy-focused role that values your nursing voice and expertise
  • Career development opportunities to grow beyond traditional nursing roles
  • Supportive, collaborative team culture committed to excellence and integrity

If you're a registered nurse seeking purpose-driven work,professional growth, and the flexibility to balance your life andcareer-this is your opportunity. Apply today and help shape the future of healthcare quality in Pennsylvania.
Requirements
Be available as a full-time consultant, approximately 37.5 hours per week;
• Possess a current license to practice as a Registered Nurse issued by the Pennsylvania
State Board of Nursing; or possess a non-renewable temporary practice permit issued
by the Pennsylvania State Board of Nursing. Resources possessing non-renewable
temporary practice permits must obtain licensing as a Registered Nurse within the
one-year period as defined by the Pennsylvania State Board of Nursing;
• Possess a documented work history of three (3) or more years of professional
experience with medical assistance, health care services or human services or any
equivalent combination of experience and training;
• Possess basic computer skills, including familiarity with Microsoft Office programs.
Principal Duties and Responsibilities (RN - Medical Assistance Inpatient Utilization Review & Discharge Planning)
  • Conduct clinical utilization reviews for medical-surgical inpatient hospitalizations under the Medical Assistance (MA) Program by evaluating medical records, admission criteria, continued stay indicators, and treatment plans to determine medical necessity, appropriateness, and level of care.
  • Apply registered nursing clinical judgment and evidence-based medical-surgical standards to ensure MA beneficiaries receive safe, effective, and timely inpatient care consistent with MA coverage requirements and regulatory guidelines.
  • Perform prospective, concurrent, and retrospective reviews of inpatient admissions to assess appropriate level of care (e.g., inpatient vs. observation), length of stay, and readiness for discharge.
  • Evaluate discharge planning documentation to ensure timely, safe, and effective transitions of care, including coordination of post-acute services such as home health, durable medical equipment (DME), skilled nursing facility (SNF), rehabilitation, behavioral health follow-up, and community-based supports.
  • Assess provider documentation and hospital billing to ensure compliance with MA policies, inpatient reimbursement rules, and discharge planning requirements, and identify potential fraud, waste, or abuse.
  • Review clinical documentation submitted through electronic medical records, provider portals, telephone communications, fax, and U.S. mail to support utilization and discharge determinations.
  • Make authorization determinations within RN scope of practice by approving, modifying, or denying inpatient stays and post-acute services, or referring cases to physician advisors when medical necessity, level of care, or discharge disposition is unclear.
  • Collaborate with physician/medical consultants and hospital care teams to support peer-to-peer discussions regarding continued stay criteria, discharge readiness, and appropriate post-discharge level of care.
  • Document utilization review findings, clinical rationale, and discharge planning decisions in electronic systems, generating authorization notifications, denial letters, reason codes, and appeal information in compliance with MA regulations.
  • Conduct re-reviews and reconsiderations of inpatient and post-acute service decisions upon request by hospitals, providers, or facilities, in collaboration with physician/medical consultants as needed.
  • Review and prepare appeal cases related to inpatient admissions, continued stays, and discharge determinations by analyzing medical records, preparing case summaries and exhibits, and providing testimony at administrative hearings using knowledge of MA regulations and appeal procedures.
  • Interpret MA inpatient and discharge planning policies, regulations, and utilization management guidelines for hospital staff, providers, and internal stakeholders through consultation, education, and meetings.
  • Participate in interdisciplinary collaboration with hospitals, post-acute providers, medical consultants, social services, legal staff, and program leadership to support patient-centered, compliant, and efficient transitions of care.
  • Maintain professional competence through continuing education and review of current medical-surgical and care transition literature to remain current with standards of care, utilization review best practices, and regulatory changes.
  • Provide cross-coverage in other MA program areas as needed, maintaining working knowledge through training and updates to support continuity of program operations.
  • Respond to inquiries and correspondence from beneficiaries, providers, legislators, legal offices, and external agencies to explain inpatient coverage decisions, discharge planning requirements, and administrative processes.
  • Maintain accurate case documentation and records in accordance with MA regulations, accreditation standards, and organizational policies.
  • Perform related duties and special projects as assigned, with expectations and performance standards communicated at the time of assignment.
  • When required, work at Department-designated locations. The primary work location is Harrisburg, PA, where appropriate workspace, technology, and resources will be provided to support assigned responsibilities.

Benefits
Attractive Compensation plan.Holiday and Vacation program.

Apply