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Rn Reviewer Jobs (NOW HIRING)

Massgeneralbrigham

Senior Nurse Reviewer

Somerville, MA · Remote

$79K - $115K/yr

Registered Nurse [RN - MA State License] - required * 3+ years of experience in clinical nursing required * 2+ years of experience in a quality assurance or clinical review role required Skill for ...

Mass General Brigham

Senior Nurse Reviewer

Somerville, MA · On-site +1

$79K - $115K/yr

Registered Nurse [RN - MA State License] - required * 3+ years of experience in clinical nursing required * 2+ years of experience in a quality assurance or clinical review role required Skill for ...

RN

Registered Nurse, Patient Services

Syracuse, NY · On-site

$75K - $87K/yr

The Patient Services RN serves as the vital clinical link between patients, field clinicians, and ... Review and approve Resumption of Care (ROC) orders * Manage Start of Care (SOC) NTU and MD ...

RN

Registered Nurse, Patient Services

Syracuse, NY · On-site

$75K - $87K/yr

The Patient Services RN serves as the vital clinical link between patients, field clinicians, and ... Review and approve Resumption of Care (ROC) orders * Manage Start of Care (SOC) NTU and MD ...

RN

Registered Nurse, Patient Services

Syracuse, NY · On-site

$75K - $87K/yr

The Patient Services RN serves as the vital clinical link between patients, field clinicians, and ... Review and approve Resumption of Care (ROC) orders * Manage Start of Care (SOC) NTU and MD ...

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How much do rn reviewer jobs pay per hour?

As of Jun 22, 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 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 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 an RN reviewer?

An RN reviewer is a registered nurse responsible for evaluating medical records, documentation, and clinical information to ensure accuracy, compliance, and quality standards. They often work in healthcare quality assurance, insurance, or legal settings, using their nursing expertise to assess patient care documentation and support decision-making processes.

How to make an extra $1000 a month as a nurse?

Rn reviewers can increase their income by taking on per diem or agency nursing shifts, which often pay higher rates, or by offering specialized services such as telehealth consultations if they have relevant certifications. Developing additional skills or certifications in high-demand areas can also open opportunities for higher-paying side work or consulting roles.

What are RN Reviewers?

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.

How to make 300,000 a year as a nurse?

To earn $300,000 annually as an RN, nurses often pursue specialized roles such as nurse anesthetist, nurse practitioner, or clinical nurse specialist, which require advanced certifications and education like a master's or doctoral degree. Gaining extensive experience, working in high-demand settings, and sometimes taking on overtime or travel assignments can also increase income potential.

What are the key skills and qualifications needed to thrive as an RN Reviewer, and why are they important?

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.
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Rn Reviewer jobs near you

Senior Nurse Reviewer

Massgeneralbrigham

Somerville, MA • Remote

$79K - $115K/yr

Full-time

Posted 13 days ago

Job description

Site: Mass General Brigham Incorporated


Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


Job Summary

The Senior Nurse Reviewer is responsible for the coordination, facilitation, and appeal of the clinical components of charge audits and forensic review findings. This includes audits conducted at Mass General Brigham (MGB) facilities in accordance with the MGB Charge Audit Policy and established departmental policies/procedures. The Senior Nurse Reviewer plays an important role in appealing challenges to charging policy and practice. The increased use of pre- and post-payer audits impacts MGB net revenue, to which the incumbent responds.
Essential Functions
-Coordinates the scheduling of audits with external third-party audit representatives/payors to initiate the audit process.
-Prepares detailed packages for cases selected by audit representatives, including necessary documents needed to initiate the audit process.
-Prepares audit responses and appeals for complex charge and forensic audits.
-Documents, summarizes, and defends audit findings in a clear, concise, and effective manner to preserve MGB appeal rights.
-Conducts post-audit research to support and defend cited charges by obtaining additional documentation.
-Updates internal systems used for tracking and reporting findings, including but not limited to patient accounting systems, spreadsheets, and databases, to facilitate monthly management reporting.
-Provides subject matter knowledge on various billing, coding, and clinical topics to the audit representatives and other key customers as needed.


Qualifications

  • Bachelor's Degree in Nursing required

  • Registered Nurse [RN - MA State License] - required

  • 3+ years of experience in clinical nursing required

  • 2+ years of experience in a quality assurance or clinical review role required


Skill for Success

  • It is essential that the candidate possesses strong appeal writing experience, as this skill is critical for successfully supporting and defending clinical charge audit findings during the appeals process.

  • Strong analytical skills with the ability to interpret clinical data and identify trends.

  • Excellent communication and interpersonal skills, with the ability to collaborate effectively with multidisciplinary teams.

  • Proficient in electronic health record (EHR) systems and clinical documentation tools.

  • Strong organizational skills and attention to detail.

  • Ability to provide constructive feedback and facilitate training for nursing staff.

Working schedule:

  • Remote, M-F eastern standard business hours. Requires a quiet, secure, HIPAA-compliant working station


Additional Job Details (if applicable)


Remote Type

Remote


Work Location

399 Revolution Drive


Scheduled Weekly Hours

40


Employee Type

Regular


Work Shift

Day (United States of America)


Pay Range

$79,560.00 - $115,720.80/Annual


Grade

7


At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.


EEO Statement:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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