ZipRecruiter

Log In

2

Work From Home Rn Medical Record Review Jobs (NOW HIRING)

BrightStar Care API

Registered Nurse Case Manager

Join a leader in the home health care and medical staffing industry. If providing compassionate ... Non-skilled work in member's homes to prevent hospital readmission * Teaching and helping members ...

Managed Staffing

HEDIS Reviewer

MI · Remote

$44 - $45/hr

HEDIS Reviewer - Work From Home (Michigan Only) Location: Remote - Must reside in Michigan (MI) Schedule: Monday - Friday, 8:00 AM - 5:00 PM Job Summary: HEDIS Reviewer III (Medical Record Review ...

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

At RELI Group, our work is grounded in purpose. We partner with government agencies to solve ... Perform automated and complex medical record and claim reviews to make coverage determinations ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

At RELI Group, our work is grounded in purpose. We partner with government agencies to solve ... Perform automated and complex medical record and claim reviews to make coverage determinations ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Communicates results of reviews verbally, in the medical record, and through official written ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Communicates results of reviews verbally, in the medical record, and through official written ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Communicates results of reviews verbally, in the medical record, and through official written ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

next page

Showing results 1-20

People also search for

All JobsRn Medical Record Review JobsWork From Home Rn Medical Record Review Jobs

Work From Home Rn Medical Record Review information

See salary details

$24

$44

$70

How much do work from home rn medical record review jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for work from home rn medical record review in the United States is $44.91, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $53.37 per hour, depending on experience, location, and employer.

What is a Work From Home RN Medical Record Review?

A Work From Home RN Medical Record Review is a registered nurse (RN) who evaluates and analyzes patients’ medical records remotely, often for insurance companies, healthcare organizations, or legal purposes. Their primary responsibilities include reviewing documentation for accuracy, completeness, and compliance with regulations or clinical guidelines. This role requires a strong understanding of medical terminology, clinical practices, and confidentiality standards. It allows nurses to leverage their clinical expertise in a non-bedside, remote setting, providing flexibility and work-life balance.

What is the difference between Work From Home Rn Medical Record Review vs Work From Home Medical Coding Specialist?

AspectWork From Home Rn Medical Record ReviewWork From Home Medical Coding Specialist
CredentialsRegistered Nurse (RN) licenseMedical coding certification (CPC, CCS, etc.)
Work EnvironmentHome-based, reviewing patient recordsHome-based, coding medical procedures and diagnoses
Industry UsageHealthcare, insurance, legal casesHealthcare, insurance billing
Common Search/ComparisonYesYes

Both roles are remote healthcare positions requiring specialized certifications. The RN Medical Record Review focuses on evaluating patient records for accuracy and compliance, while the Medical Coding Specialist assigns codes for billing and documentation. Understanding these differences helps job seekers find the right remote healthcare role that matches their credentials and career goals.

What are the key skills and qualifications needed to thrive as a Work From Home RN Medical Record Review, and why are they important?

To thrive as a Work From Home RN Medical Record Review, you need a current RN license, strong clinical knowledge, and experience with medical documentation and chart review. Familiarity with electronic health records (EHRs), coding systems like ICD-10, and utilization management software is typically expected. Attention to detail, critical thinking, and effective written communication help ensure accuracy and clarity in remote documentation. These skills are vital for maintaining compliance, supporting quality assurance, and ensuring the integrity of patient records in a remote work environment.

What are some common challenges faced by Work From Home RN Medical Record Reviewers, and how can they be managed?

Work From Home RN Medical Record Reviewers often face challenges such as managing distractions in a home environment, maintaining data security, and meeting productivity targets without in-person supervision. To overcome these, it's important to set up a dedicated workspace, follow strict privacy protocols, and use time management techniques to stay focused. Regular communication with your team and utilizing secure digital platforms can also help ensure accuracy and compliance in your reviews.
More about Work From Home Rn Medical Record Review jobs
What cities are hiring for Work From Home Rn Medical Record Review jobs? Cities with the most Work From Home Rn Medical Record Review job openings:
What states have the most Work From Home Rn Medical Record Review jobs? States with the most job openings for Work From Home Rn Medical Record Review jobs include:
What job categories do people searching Work From Home Rn Medical Record Review jobs look for? The top searched job categories for Work From Home Rn Medical Record Review jobs are:
Work From Home Rn Medical Record Review jobs near you
Infographic showing various Work From Home Rn Medical Record Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 71% Full Time, 23% Part Time, 1% Temporary, and 4% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $93,419 per year, or $44.9 per hour.
Registered Nurse - Medical Review Specialist

Registered Nurse - Medical Review Specialist

Avosys Technology, Inc.

Remote

Full-time

Posted 11 days ago

Job description

ABOUT AVOSYS
Avosys is a growing integrator of professional, technological and management solutions services. Founded in 1998, Avosys provides services nationwide to Federal, Commercial, Local and State clients. We recognize the foundation of our firm is our people and we continue to rise above our competition by hiring the best.
DESCRIPTION
Is it your calling to serve our Nation's Heroes? Avosys is seeking a Registered Nurse - Medical Review Specialist to provide services to the military and their families.
EMPLOYMENT WITH AVOSYS
  • Maximize family time with no weekend, Holiday, or on-call requirements
  • Maintain work-life balance with guaranteed 8-hour shifts
  • Achieve peace of mind with malpractice insurance provided at no cost

TITLE: Registered Nurse - Medical Review Specialist
LOCATION: Remote work from home.
HOURS: Monday thru Friday 8 hour shift with core hours between 8-2 CST 9-3 EST, no overtime is allowed.
SUMMARY:
Perform clinical reviews of Medicare Part A and Part B claims for Medical Review, Redeterminations/Appeals (Appeals), and Prior Authorization requests (collectively, the "Services") in accordance with CMS (Centers for Medicare & Medicaid Services) requirements.
QUALIFICATIONS:
  • Minimum of two (2) years' clinical experience
  • Active and current Registered Nurse license
  • Bachelor's required
  • Excellent written and oral communication skills
  • Demonstrated experience with evaluating medical and health care delivery issues
  • Strong computer skills to include Microsoft Office proficiency
  • Preferred (but not required) qualifications:
  • Insurance industry experience
  • Oral and written English-Spanish bilingual skills

RESPONSIBILITIES: include, but not limited to:
  1. Clinical review of services:
    • Review medical record documentation within CMS timeliness parameters (i.e., 20 days from receipt of the medical record for pre-payment reviews and 50 days from receipt of the medical record for post payment reviews).
    • Utilize the applicable Medicare policies (i.e., Local Coverage Determinations, National Coverage Determinations, Internet-Only Manual (IOM) citations, inpatient tools, etc.) to ensure the services comply with all Medicare regulations and documentation requirements.
    • Review documentation for medical necessity per guidelines outlined in the Social Security Act 1862(a)(1).
    • Ensure that all documentation includes a valid signature consistent with the signature requirements.
  2. Documentation of rationale for processing decisions:
    • Provide a claim sample of three (3) claims to Companies via established protocols and timeliness parameters (i.e., 18 days from receipt of the medical record for pre-payment reviews and 48 days from receipt of the medical record for post payment reviews) for quality review prior to finalization of documentation of reason for payment, reduction, or denial of service to ensure accuracy of claim decision making.
    • Companies will review the three-claim sample for accuracy of claim decision and will make and return decisions to the MRS within 24 hours or less.
    • Complete the documentation of the reason for payment, reduction, or denial of service for all claims on an electronic decision template to be provided by Companies. This rationale must be in sentence format so that it may be inserted directly into the response to the provider, must be clear and well-written, and contain sufficient information to educate the providers on how the review decision was made.
    • Return documented decision electronically to Companies via established protocols and timeliness parameters (i.e., 20 days from receipt of the medical record for pre-payment reviews and 50 days from receipt of the medical record for payment reviews).
    • Complete the review results letter in the Companies' letter writing system within 35 days from receipt of the medical record for pre-payment reviews and no later than 60 days from receipt of the medical record for post payment reviews.
    • Document all case activity in Companies' provider tracking system on the day the activity occurs.
    • Complete one-on-one provider education (i.e., webinar, conference call, etc.) within 30 days of sending out review results letter.
    • Respond to provider inquiries related to case and/or claims throughout the course (i.e. in 24 hours or less) of review.
    • If additional clinical guidance is required, complete the Contractor Medical Director ("CMD") assistance form, track response, and update review accordingly.
    • Conduct telephone development for missing or additional records for easily curable errors.
    • Notate date of receipt of additional documentation received in the Companies' provider tracking system.
    • Upon request by Companies, initiate or participate in provider teaching activities, creating written teaching material, providing one-on-one education or education to a group as a result of an MR review.
    • If fraud activity is suspected, immediately complete initial referral packet for external entity referral and return the packet to the Companies.
    • Complete referrals to Companies' provider outreach and education ("POE") area in provider tracking system for cases that have a moderate or major error rate.
    • Lead and Alternate Lead will participate in all monthly departmental training and meetings, and all Staff will participate as requested.
    • Submit all cases for review and approval for quality and closure of cases.

Job responsibilities are subject to change to meet Military Treatment Facility requirements. Additional immunization record, security and background check requirements are also considered as qualifying criteria.
Position Type: Full Time
Location: Remote
Industry: Government Contracting
Shift: Day Business Hours
Travel: No
Salary: Based on Experience
Telework: Yes
Equal Opportunity Employer/Veterans/Disabled
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact (210) 888-0775 or Jobs@Avosys.com for assistance.

Apply