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Rn Reviewer Jobs (NOW HIRING)

Dane Street, LLC

Registered Nurse Reviewer

Dane Street has embarked on a program where we are looking for Registered Nurses to perform reviews and clinical summaries for disability claims. The expected report turnaround time for the reviewer ...

Cohere Health

Lead RN Reviewer

$35 - $37/hr

Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in ...

Zelis

Clinical Nurse Reviewer

Boston, MA · On-site

$59K - $75K/yr

Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

Zelis

Clinical Nurse Reviewer

Atlanta, GA · On-site

$59K - $75K/yr

Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

Zelis

Clinical Nurse Reviewer

Plano, TX · On-site

$59K - $75K/yr

Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

Zelis

Clinical Nurse Reviewer

Saint Louis, MO · On-site

$59K - $75K/yr

Nurse Reviewer The Nurse Reviewer is primarily responsible for conducting post-service, pre or post ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

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Rn Reviewer information

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$28

$37

$42

How much do rn reviewer jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for rn reviewer in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What is an RN reviewer?

RN Reviewers are registered nurses who evaluate medical records, clinical documentation, and healthcare cases to ensure accuracy, compliance, and quality of care. They often work for insurance companies, hospitals, or healthcare organizations, reviewing patient charts to determine if services meet established guidelines. RN Reviewers play a critical role in utilization management, case review, and quality assurance processes. Their work helps ensure that patients receive appropriate care and that healthcare providers adhere to best practices and regulatory requirements.

What are the key skills and qualifications needed to thrive as an RN reviewer?

To thrive as an RN Reviewer, you need a current registered nurse license, strong clinical judgment, and experience in case review or utilization management. Familiarity with medical review software, electronic health records (EHRs), and knowledge of regulatory standards like CMS guidelines is typically required. Excellent analytical skills, attention to detail, and effective written and verbal communication help you stand out in this role. These competencies ensure accurate case evaluations, regulatory compliance, and effective collaboration with healthcare teams.

What are some common challenges RN reviewers face when evaluating clinical documentation, and how can they overcome them?

One common challenge Rn Reviewers encounter is ensuring accuracy and completeness in complex clinical documentation, which can vary widely between providers and healthcare settings. Navigating inconsistent or incomplete records requires strong attention to detail and effective communication with clinical staff to clarify ambiguities. Overcoming these challenges often involves staying updated on best practices, leveraging electronic health record (EHR) tools, and collaborating closely with interdisciplinary teams to ensure all relevant information is accurately captured and compliant with regulatory standards.

What is the difference between Rn Reviewer vs Rn?

AspectRn ReviewerRn
CredentialsRegistered Nurse (RN) license, additional certification in medical review or quality assuranceRegistered Nurse (RN) license, standard nursing credentials
Work EnvironmentHealthcare facilities, insurance companies, or medical review organizationsHospitals, clinics, or healthcare settings
Job FocusReviewing medical records for insurance claims, compliance, or quality assuranceProviding direct patient care, nursing duties
Industry UsageInsurance, healthcare quality, medical reviewHealthcare, hospital, clinical settings

The main difference between an Rn Reviewer and an Rn is that the Rn Reviewer specializes in reviewing medical records and insurance claims, often working in insurance or quality assurance roles. In contrast, an Rn provides direct patient care in healthcare settings. Both roles require an RN license, but the Rn Reviewer typically has additional certifications related to medical review or compliance.

How to become an RN chart reviewer?

To become an RN chart reviewer, registered nurses typically need a valid nursing license and experience in clinical settings. Additional skills in medical record documentation, attention to detail, and familiarity with electronic health record systems are important; some roles may require specialized training or certifications in medical record review or coding.
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Rn Reviewer jobs near you
Infographic showing various Rn Reviewer job openings in the United States as of August 2026, with employment types broken down into 4% As Needed, 48% Full Time, 14% Part Time, and 34% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Nurse Reviewer, RN

Cheyenne, WY • On-site

Blue Cross Blue Shield of Wyoming
Insurance Services • 201 - 500 employees
Learn more about Blue Cross Blue Shield of Wyomingexternal

Other

Posted 28 days ago

Job description

Nurse Reviewer

As a Nurse Reviewer at BCBSWY, you will be part of an amazing team of knowledgeable professionals working to ensure appropriate care is provided to our customers.

You will be accountable for reviewing claims and appeals to determine if necessary care has been provided. You'll apply medical policy and other requirements, using Interqual, discussions with medical providers and pharmacists, and other resources to ensure patients receive the highest quality care available within fair and equitable guidelines.

To succeed in this role, you will need to be able to apply critical thinking skills, work with a team of clinical and non-clinical staff, multi-task, and have flexibility in an ever-changing healthcare system.

An active, unrestricted Registered Nurse license for the state of Wyoming is required.

BCBSWY is an Equal Opportunity Employer. We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. Qualified applicants are provided with an equal opportunity and selection decisions are based on job-related factors.

We use E-Verify to confirm employment eligibility; we DO NOT sponsor applicants for work visas.

BCBSWY is committed to the full inclusion of all qualified individuals. As part of this commitment, we will ensure that persons with disabilities are provided reasonable accommodations for the application, selection, and hiring process. If reasonable accommodation is needed, please contact: HR@BCBSWY.com

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