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

Ourhrconnect

RN Medical Reviewer II

Carolina, RI · Remote

Provides support and review of medical claims and utilization practices. Description Logistics ... This is a full-time, remote work-from-home position . All training will be conducted virtually.

Ourhrconnect

RN Medical Reviewer II

Carolina, RI · Remote

Provides support and review of medical claims and utilization practices. Description Logistics ... This is a full-time, remote work-from-home position . All training will be conducted virtually.

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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.
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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:
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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.
Remote RN - Medical Claims Reviewer

Remote RN - Medical Claims Reviewer

Broadway Ventures

Nashville, TN • Remote

Full-time

Posted 25 days ago

Job description

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 QualificationsLicensure:
  • 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).