ZipRecruiter

Log In

2

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

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 ...

Dane Street, LLC

Peer/Record Review Quality Analyst

Reviews reports accompanying medical records to ensure that the report is complete and that all ... WORK FROM HOME TECHNICAL REQUIREMENTS: Supply and support their own internet services. Maintaining ...

MedWatch, LLC

Medical Review Specialist/RN

$64K - $68K/yr

MedWatch accepts clinical information from the provider, the utilization review department of the ... Work Environment / Physical Demands: This position is in a typical office / home office environment ...

next page

Showing results 1-20

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.
RN Utilization Management Reviewer

RN Utilization Management Reviewer

Sagility LLC

Remote

$35 - $40/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Sagility rating

4.6

Company rating: 4.6 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

64th of 72 rated call and contact centers

Job description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
RN Utilization Management Reviewer
Job Description:
We are currently hiring a talented RN, Utilization Management Reviewer. This role will be responsible in day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS compliance standards in the area of service decisions and organizational determinations. Successful candidates must hold a valid, current license issued by the Massachusetts Board of Registration in Nursing.
Key responsibilities:
  • Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not limited to surgical procedures, Medicare Part B medications, Long Term Services and Supports (LTSS), and Home Health (HH)
  • Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical expertise to interpret clinical criteria to determine medical necessity of services
  • Communicates results of reviews verbally, in the medical record, and through official written notification to the primary care team, specialty providers, vendors and members in adherence with regulatory and contractual requirements
  • Provides decision-making guidance to clinical teams on service planning as needed
  • Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in accordance with Standard Operating Procedures
  • Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy
  • Works with UM Manager and other clinical leadership to ensure that departmental and organizational policies and procedures as well as regulatory and contractual requirements are met
  • Additional duties as requested by supervisor
  • Maintains knowledge of CMS, State and NCQA regulatory requirements

Education Requirements:
  • RN - Associate's Degree required, Bachelor's Degree preferred
  • RN, current license issued by the Massachusetts Board of Registration in Nursing
  • CCM (Certified Case Manager) a plus

Required Experience (must have):
  • 1 to 2 years Utilization Management experience.
  • 2 or more years working in a clinical setting

Desired Experience (nice to have):
  • 2 or more years of Home Health Care experience
  • 2 or more years working in a Medicare Advantage health Plan

Required Knowledge, Skills & Abilities (must have):
  • Ability to complete assigned work in a timely and accurate manner
  • Knowledge of the Utilization management process
  • Ability to work independently

Desired Knowledge, Skills, Abilities & Language (nice to have):
  • Ability to apply predetermined criteria (e.g., Medical Necessity Guidelines, InterQual) to service decision requests to assess medical necessity
  • Flexibility and understanding of individualized care plans
  • Ability to influence decision making
  • Strong collaboration and negotiation skills
  • Strong interpersonal, verbal, and written communication skills
  • Comfort working in a team-based environment
  • Knowledge of Medicare and Mass health services and benefits

Salary: $35.00 - $40.00 Hourly pending experience.
Hours: Monday through Friday 9AM to 5:30PM Eastern Time. May require weekends
This is a fully remote work at home role. You must have a secure, private wok at home area with a hardwired internet connection with speeds greater than 5MB upload and 10MB download.
Sagility Offers Competitive Benefits Including:
  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Short-Term and Long-Term Disability
  • Flexible Spending Account
  • Life Assistance Program
  • 401K with employer contribution
  • PTO and Sick Time
  • Tuition Reimbursement

Join our team, we look forward to talking with you!
An Equal Opportunity Employer/Vet/Disability
Location:
Work@Home USAUnited States of America

What Sagility employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply