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Sarah Jenkins
Remote Chart Review Nurse jobs in the United States
Job type
Min. salary, $/year
Level
Healthcare organizations across the USA are actively seeking skilled chart review nurses to support remote documentation and quality assurance initiatives. With 500+ open positions available right now, this growing field offers a rewarding pathway for nurses who thrive on meticulous review and compliance work. As demand for accurate medical record audits rises nationwide, chart review nurse remote jobs continue to expand across diverse healthcare settings.
Success in this role calls for strong clinical knowledge, exceptional attention to detail, and familiarity with electronic health record systems and coding guidelines such as ICD-10 and CPT. Employers value nurses who can interpret clinical documentation accurately, identify discrepancies, and communicate findings clearly to interdisciplinary teams. A current RN license, prior experience in utilization review or case management, and strong analytical skills make candidates highly competitive for chart review nurse vacancies.
Remote chart review nurse roles typically offer flexible scheduling, allowing professionals to balance work-life demands while contributing to critical healthcare quality initiatives from home offices nationwide. As telehealth and virtual auditing expand, employers across the USA increasingly hire a chart review nurse to streamline documentation accuracy and reduce compliance risks. This shift reflects a broader trend toward remote clinical support roles within the healthcare industry.
If you're ready to advance your nursing career through meaningful remote work, explore current chart review nurse positions available through Global Work AI. Take the next step toward a flexible, impactful career that values your clinical expertise and attention to detail.
GuideWell Source
Review and analyze complex healthcare claims for medical necessity and appropriateness of care. Conduct clinical reviews, interpret CMS guidelines, and identify issues such as overpayment or fraud. Provide guidance to team members and develop recommendations for corrective actions.
remote, AL, United StatesFull TimeJunior (<2 years)
Sedgwick
Perform clinical assessments and evaluate patient conditions, including treatment utilization and compliance. Collaborate with physicians, claims examiners, and other parties to negotiate care levels.
remote, United States$63k – $65k/yrFull TimeJunior (<2 years)
Methodist Health System
Review medical records to enhance clinical documentation quality, ensuring accurate representation of illness severity. Manage multiple priorities including chart reviews and query follow-ups.
remote, United StatesFull TimeJunior (<2 years)
Providence
Conduct prospective, retrospective, and concurrent utilization reviews for Southern CA ministries. Perform clinical reviews and assess medical records daily during admissions for all payers as required by health plans.
remote, CA, United StatesPart TimeJunior (<2 years)
Centene Corporation
Analyze prior authorization requests for medical necessity and appropriate care levels. Collaborate with healthcare providers and teams to ensure timely service reviews. Document and maintain clinical information in health management systems, ensuring compliance with regulations.
remote, TX, United States$54k – $98k/yrFull TimeJunior (<2 years)
CareSource
Process medical necessity reviews for healthcare service authorization, assist with discharge planning, and coordinate care for members. Engage with medical directors for clinical expertise, monitor healthcare service delivery, and refer quality issues to Quality Improvement.
remote, MA, United States$75k – $121k/yrFull TimeMiddle (2-4 years)
LCMC Health
Develop individualized care plans, assess patient health status, identify treatment gaps, coordinate care, ensure discharge services, triage calls, manage home monitoring alerts, provide health information, document workflows in EPIC, and educate patients on wellness and disease management.
remote, LA, United StatesPart TimeJunior (<2 years)
Peraton
Conduct medical record reviews and apply clinical judgment to claim payment decisions. Perform research on medical claims data to identify issues and support fraud investigations.
remote, United States$51k – $82k/yrFull TimeJunior (<2 years)Health Plan of San Joaquin/Mountain Valley Health Plan
Conduct concurrent reviews of inpatient activities, ensuring compliance with care plans and regulatory requirements. Collaborate with providers to resolve care issues, make recommendations for transfers and discharge planning, and document activities in HPSJ systems.
remote, CA, United StatesFull TimeMiddle (2-4 years)
Connecticut Children's
Conducts utilization reviews for assigned patients, ensuring compliance with medical necessity guidelines. Performs concurrent and retrospective clinical reviews, documents resource utilization, and collaborates with healthcare teams to optimize patient care.
remote, CT, United StatesFull TimeMiddle (2-4 years)
Gainwell Technologies LLC
Coordinate and perform appeal-related duties, including analyzing and responding to provider appeals. Review documentation to ensure all aspects of the appeal are addressed accurately. Prepare case files and summaries for hearings, and participate in virtual and on-site hearings.
remote, United States$69k – $99k/yrFull TimeSenior (5+ years)
Revitalize Home Healthcare
Review OASIS-E2 assessments for accuracy and consistency before submission. Confirm alignment of OASIS, visit notes, therapy evaluations, and medication profiles. Verify ICD-10 coding and PDGM accuracy, providing actionable feedback to clinicians.
remote, FL, United States$81k – $91k/yrPart TimeJunior (<2 years)
Donato Technologies Inc
Develop high-difficulty clinical tasks and evaluation criteria, synthesize longitudinal charts, and assess clinical accuracy and safety. Apply scoring rubrics to evaluate outputs for clinical reasoning and documentation quality.
remote, United StatesFull TimeLead / Manager
Sentara Health
Conduct utilization review services, including prior authorization for inpatient and outpatient reviews. Ensure compliance with treatment setting criteria and regulatory requirements. Communicate pertinent clinical information effectively, both in writing and verbally.
remote, WY, United States$90k – $136k/yrFull TimeMiddle (2-4 years)
WNS Global Services
Conduct concurrent inpatient utilization reviews using InterQual criteria to assess medical necessity for admissions and continued stays. Collaborate with clinical teams to gather information and support level-of-care decisions.
remote, United States$75k/yrFull TimeJunior (<2 years)
Amerihealth Caritas
Evaluate medical necessity for inpatient and outpatient services, ensuring compliance with clinical guidelines and regulations. Review provider requests, gather medical documentation, and make determinations based on clinical criteria.
remote, United StatesFull TimeMiddle (2-4 years)
Virginia Information Technologies Agency
Review and develop mortality case summaries for individuals receiving DBHDS services, focusing on medical records and related documents. Analyze sequences of events leading to deaths and identify contributing factors.
remote, WY, United States$70k – $91k/yrFull TimeJunior (<2 years)
The IMA Group
Review medical records for disability, workers’ compensation, and insurance-related cases. Summarize clinical information into structured reports, identify key findings and gaps in documentation, and prepare case summaries for physician review.
remote, United States$90k – $120k/yrFull TimeMiddle (2-4 years)
MedElite Group, LLC.
Review patient charts and communicate with the Clinical department regarding irregularities. Administer validated rating scales and initiate behavioral health care planning. Revise care plans for patients whose status changes and conduct interdisciplinary care plan meetings.
remote, FL, United States$58k – $73k/yrFull TimeEntry with Degree
SCAN Health Insurance
Review and analyze complex healthcare claims from a medical perspective. Conduct audits of medical claims, identify documentation needs, and interpret CMS guidelines.
remote, CA, United States$79k – $113k/yrFull TimeMiddle (2-4 years)
Alternate Solutions Health Network
Provide skilled nursing care in patients' homes as directed by attending physicians. Respond to after-hours patient needs and manage time efficiently while working autonomously. Assist with chart reviews or patient phone calls when there are minimal after-hours needs.
remote, OH, United States$15k/yrFull TimeJunior (<2 years)Peraton
Conduct medical record reviews and apply clinical judgment to claim payment decisions. Perform research on medical claims data to identify issues and support fraud investigations.
remote, United States$51k – $82k/yrFull TimeSenior (5+ years)
ePathUSA
Perform complex medical record and claim reviews for Medicare Part A and B, making coverage determinations based on policies and guidelines. Evaluate AI-assisted processes for compliance and support Program Integrity reviews to detect fraud, waste, and abuse.
remote, IA, United States$77k – $97k/yrFull TimeMiddle (2-4 years)
Telligen
Conduct utilization review and medical management for services, ensuring appropriateness of care based on criteria. Train and mentor team members, perform medical record reviews, and assist in compliance reporting.
remote, CA, United StatesPart TimeSenior (5+ years)
Dane Street, LLC
Ensure timely completion and accuracy of physician reports, evaluating quality against client standards. Communicate with clients and physicians to clarify report questions and gather necessary information.
remote, United StatesFull TimeEntry with Degree
Astrana Health, Inc.
Conduct prior authorization and retrospective reviews for inpatient admissions, outpatient procedures, and durable medical equipment. Refer cases to Medical Directors as necessary and maintain compliance with state and federal regulations.
remote, TX, United States$60k – $81k/yrFull TimeJunior (<2 years)
Medica
Conduct medical record reviews and clinical quality audits to ensure compliance with quality standards. Collect and validate clinical documentation, prepare audit findings, and support quality programs through data abstraction.
remote, AR, United States$70k – $105k/yrFull TimeSenior (5+ years)
RediMinds, Inc
Review incoming case files for completeness and accuracy, validate system-generated summaries, quality-check clinicians’ written reviews, and perform final quality assurance on determination letters.
remote, United StatesFull TimeJunior (<2 years)
Ensemble Health Partners
Lead Utilization Review RN oversees patient care delivery, ensuring medical necessity and appropriate resource utilization. Responsibilities include conducting daily medical necessity reviews, coordinating denial management processes, and facilitating discharge planning.
remote, United States$79k – $107k/yrFull TimeSenior (5+ years)
company
Investigate member and provider appeals, grievances, and complaints. Review medical necessity requests and clinical documentation for accuracy. Conduct clinical evaluations and manage inventory to meet regulatory timelines.
remote, Albany, NY, United States$62k – $129k/yrFull TimeMiddle (2-4 years)
Machinify
Perform medical claims audit reviews for inpatient and outpatient services, applying medical review guidelines. Document findings and generate audit letters. Support findings during appeals and collaborate with the audit team to identify vulnerabilities.
remote, United StatesFull TimeSenior (5+ years)
All Care To You
Review authorization requests for medical necessity, documenting all steps in the authorization system. Process requests within established time frames, utilizing CMS and Health Plan criteria. Conduct retrospective reviews and refer cases to the Medical Director as needed.
remote, United StatesFull TimeSenior (5+ years)
COMAGINE HEALTH
Conduct clinical reviews for medical necessity, appropriateness, and quality of healthcare services. Evaluate service requests against established clinical criteria and collaborate with clinical teams and physician consultants.
remote, IA, United StatesFull TimeSenior (5+ years)
NTT DATA Services
Conduct clinical reviews of medical records to evaluate medical necessity for appeals. Prepare detailed case reviews and recommendations for Medical Directors. Ensure compliance with regulations and standards while maintaining accurate appeal records.
remote, FL, United States$76k/yrFull TimeMiddle (2-4 years)
Tristar Insurance
Perform Workers’ Compensation utilization review including prospective, concurrent, expedited, and retrospective reviews to assess medical necessity. Evaluate treatment requests against clinical information and guidelines, referring to Peer Physicians as needed.
remote, United States$82k – $88k/yrFull TimeJunior (<2 years)
Excellus BCBS
Investigate member and provider appeals, grievances, and complaints. Review medical necessity requests and clinical documentation for accuracy. Conduct clinical evaluations and manage inventory to meet regulatory timelines.
remote, Albany, New York, United States$62k – $129k/yrFull TimeMiddle (2-4 years)CorVel Career Site
Manage daily file flow for Medical Review, ensuring quality and tracking special files. Conduct performance evaluations for direct reports and oversee human resources matters. Analyze data trends to manage nursing staff workflow and respond to internal inquiries.
remote, TX, United States$70k/yrFull TimeJunior (<2 years)Gainwell Technologies LLC
Perform clinical reviews of medical records to assess medical necessity and appropriateness of care. Document review decisions and rationale, determine approvals, and process consultant decisions.
remote, United States$78k – $88k/yrFull TimeSenior (5+ years)Machinify
Perform medical claims audit reviews for government clients, ensuring compliance with medical review guidelines. Document findings, generate audit letters, and support findings during appeals. Collaborate with the audit team to identify vulnerabilities and improve medical policies.
remote, United StatesFull TimeSenior (5+ years)
CERIS
Manage daily file flow for Medical Review, ensuring quality and tracking special files. Conduct performance evaluations for staff, maintain error ratios, and handle HR matters. Analyze data trends to manage workflow and respond to internal inquiries.
remote, TX, United States$70k/yrFull TimeJunior (<2 years)10,000,000+ more jobs available!
