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Rn Reviewer Jobs in Virginia (NOW HIRING)

Peraton

Nurse Reviewer - Medicaid

Reston, VA · On-site

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Peraton

Nurse Reviewer - Medicaid

Herndon, VA · On-site

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Acentra Health

Clinical Reviewer-RN

Mclean, VA · On-site

Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer-RN to join our growing team. Job Summary: The purpose of this position is to review medical records against ...

Acentra Health

Clinical Reviewer-SCA

Mclean, VA · On-site

Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer to join our ... For RN or SW - Bachelor's Degree from an accredited college or university in a related field.

Sentara Healthcare

Registered Nurse

Norfolk, VA · On-site

Pass Registered Nurses review charts for accuracy, confirm vaccination/testing status, and maintain communication with physician offices throughout the day. They enter procedure orders and care plans ...

Sentara

Registered Nurse

Norfolk, VA · On-site

Pass Registered Nurses review charts for accuracy, confirm vaccination/testing status, andmaintaincommunication with physician offices throughout the day. They enter procedure orders and care plans ...

Sentara

Registered Nurse

Norfolk, VA

$10K/mo

Pass Registered Nurses review charts for accuracy, confirm vaccination/testing status, andmaintaincommunication with physician offices throughout the day. They enter procedure orders and care plans ...

Peraton

Medical Review Nurse- Medicare

Herndon, VA · On-site

$66K - $106K/yr

We are looking to add a Nurse Reviewer to our SGS team of talented professionals. What you'll do ... Experience in the medical field as a Registered Nurse or other clinician, and/or experience in ...

Peraton

Medical Review Nurse- Medicare

Reston, VA · On-site

$66K - $106K/yr

We are looking to add a Nurse Reviewer to our SGS team of talented professionals. What you'll do ... Experience in the medical field as a Registered Nurse or other clinician, and/or experience in ...

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All JobsRn Reviewer JobsRn Reviewer Jobs in Virginia

Rn Reviewer information

See Virginia salary details

$28

$36

$42

How much do rn reviewer jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for rn reviewer in Virginia is $36.72, according to ZipRecruiter salary data. Most workers in this role earn between $33.85 and $41.01 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.

What are popular job titles related to Rn Reviewer jobs in Virginia?

For Rn Reviewer jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Rn Reviewer jobs in Virginia look for?

The top searched job categories for Rn Reviewer jobs in Virginia are:

Rn Reviewer jobs near you
Infographic showing various Rn Reviewer job openings in Virginia as of August 2026, with employment types broken down into 3% As Needed, 49% Full Time, 21% Part Time, and 27% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $76,373 per year, or $36.7 per hour.

Nurse Reviewer - Medicaid

Peraton

Reston, VA • On-site

$66K - $106K/yr

Other

Posted 20 days ago

Peraton rating

8.3

Company rating: 8.3 out of 10

Based on 56 frontline employees who took The Breakroom Quiz

52nd of 225 rated it services

Job description


Nurse Reviewer - Medicaid
Job Locations
US
Requisition ID
2026-169096
Position Category
Business Controls
Clearance
No Clearance Required
Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add a Medical Reviewer to our SGS team of talented professionals.

What you'll do:

The Medical Reviewer requires the individual to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions.

Responsibilities may include additional research on medical claims data and other sources of information to identify problems, review sophisticated data model output, and utilize a variety of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information. The incumbent will use a variety of tools to identify and develop cases for future administrative action, including referral to law enforcement, education, over payment recovery. Will work with external agencies to develop cases and corrective actions as well as respond to requests for data and support.

Roles and Responsibilities:

    Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
  • Research regulations and cite violations.
  • Conduct self-directed research to uncover problems in Medicaid payments made to institutional and non-institutional providers.
  • Make claim payment decisions based on clinical knowledge
  • This position may require the incumbent to appear in court to testify about work findings.
  • Ability to compose correspondence, reports, and referral summary letters.
  • Ability to communicate effectively, internally and externally.
  • Ability to handle confidential material.
  • Ability to report work activity on a timely basis.
  • Ability to work independently and as a member of a team to deliver high quality work.
  • Ability to attend meetings, trainings, and conferences as needed. Overnight travel may be required.
  • Telework available from contiguous United States.

Qualifications

Basic Qualifications:

  • Bachelors and 5 years of experience, Masters degree and 3 years of experience, Associates and 7 years of experience
  • At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity.
  • Current/Active Nursing or Physical Therapy license in state of residence.
  • Strong investigative skills
  • Strong communication and organization skills
  • Strong PC knowledge and skills
  • U.S. citizenship required

Desirable Qualifications:

  • Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
  • Knowledge of Medicaid requirements, laws, rules and regulations related to payment for services billed
  • Have a CPC (Certified Professional Coder) certificate.

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure.

Target Salary Range
$66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
EEO
EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.

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About Peraton

Sourced by ZipRecruiter

At Peraton, we re at the forefront of delivering the next big thing every day. We re the partner of choice to help solve some of the world s most daunting challenges, delivering bold, new solutions to keep people around the world safer and more secure.

Industry

It services

Company size

10,000+ Employees

Headquarters location

Herndon, VA, US

Year founded

2017

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