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$37

$42

How much do rn reviewer jobs pay per hour?

As of Jul 13, 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, insurance claims, or clinical documentation to ensure accuracy, compliance, and quality standards. They often work in healthcare, insurance, or legal settings and require strong knowledge of medical terminology and documentation practices.

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 like IV therapy or wound care can also open opportunities for higher-paying side work.

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 become a remote nurse reviewer?

To become a remote nurse reviewer, you typically need a valid nursing license, clinical experience, and strong knowledge of medical documentation and coding. Many positions require familiarity with electronic health records and certification in case review or utilization management. Applying to healthcare companies or insurance providers that hire remote nurse reviewers involves submitting a resume highlighting relevant experience and certifications.

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.
More about Rn Reviewer jobs
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What states have the most Rn Reviewer jobs? States with the most job openings for Rn Reviewer jobs include:
What job categories do people searching Rn Reviewer jobs look for? The top searched job categories for Rn Reviewer jobs are:
Rn Reviewer jobs near you
Infographic showing various Rn Reviewer job openings in the United States as of July 2026, with employment types broken down into 4% Locum Tenens, 80% Full Time, 10% Part Time, and 6% Contract. Highlights an 54% Physical, 2% Hybrid, and 44% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.
Remote RN - Medical Claims Reviewer

Remote RN - Medical Claims Reviewer

Broadway Ventures

Remote

Other

This job post has expired today. Applications are no longer accepted.

Job description

Remote Rn – Medical Claims Reviewer

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation.

Job Type: Full-time (40 hours/week) Schedule: Monday–Friday, 8:00 AM – 5:00 PM Max Salary: W-2 ($65,000/$31.25) Location: Remote (U.S. – Work from home) Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum Qualifications Licensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience plus at least two years in one of the following:
  • Home Health
  • Utilization/Medical Review
  • Quality Assurance
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
Preferred Qualifications
  • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
  • Proficiency in using multiple screens and software programs simultaneously.

If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!

What to Expect Next: After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.

Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law. Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).

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