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Sarah Jenkins
Remote Medical Chart Reviewer jobs in the United States
Job type
Min. salary, $/year
Level
The demand for skilled professionals who can accurately review patient records continues to rise across the U.S. healthcare system. Currently, 475 medical chart reviewer remote jobs are open, offering flexible opportunities for detail-oriented individuals nationwide. As healthcare organizations expand their reliance on digital documentation, qualified reviewers are needed more than ever to ensure compliance and accuracy.
Success in this field requires strong attention to detail, a solid understanding of medical terminology, and familiarity with electronic health record systems. Candidates should be comfortable interpreting clinical documentation, identifying discrepancies, and ensuring adherence to regulatory standards. Strong analytical thinking and the ability to work independently are essential, as is clear communication when collaborating with healthcare teams. Employers value candidates who balance speed with precision, making organizational skills as important as clinical knowledge.
Remote work has become standard for chart review positions, allowing professionals to contribute to healthcare quality assurance from anywhere in the country. Companies hiring for these roles often provide flexible scheduling and digital tools that streamline the review process, supporting a healthy work-life balance. As more healthcare providers hire a medical chart reviewer to support compliance and quality initiatives, the national job market continues to show steady growth.
If you're ready to bring your expertise to a growing field, now is the time to explore medical chart reviewer vacancies. Global Work AI connects skilled professionals with employers seeking reliable, detail-oriented talent across the country. Take the next step in your career and discover new opportunities today.
CareSource
Review medical records for audit activities and make payment decisions on claims. Analyze moderately complicated claims based on coding guidelines, refer suspected fraud to SIU, and prepare audit summaries for Medical Director review.
remote, United States$55k – $87k/yrFull TimeMiddle (2-4 years)CareSource
Process medical necessity reviews for behavioral health services, assist with discharge planning, and coordinate care for members. Engage with medical directors for clinical expertise, maintain knowledge of regulations, and refer quality issues to Quality Improvement.
remote, MA, United States$75k – $121k/yrFull TimeMiddle (2-4 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)
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)
HJ Staffing
Conduct Peer-to-Peer (P2P) reviews with treating physicians regarding authorization requests. Analyze clinical documentation and evaluate medical necessity and level of care. Apply CMS Medicare Advantage requirements and clinical criteria. Document P2P discussions and maintain HIPAA compliance.
remote, United StatesFull TimeLead / Manager
Mindrift
Evaluate clinical EHR vignettes for accuracy and completeness, assess clinical reasoning quality, and score benchmark items based on established criteria. Conduct independent blind reads and participate in physician adjudication to ensure quality and correctness of clinical cases.
remote, United States$101k/yrPart TimeJunior (<2 years)
Oscar Health
Conduct medical reviews to determine appropriateness of inpatient, outpatient, and pharmacy services. Document decisions in workflow tools, ensuring clarity for members. Engage in peer-to-peer discussions with providers to clarify clinical information and explain review outcomes.
remote, United States$275k/yrFull TimeSenior (5+ years)
BlueCross BlueShield of South Carolina
Perform medical reviews using clinical information and established guidelines. Document decisions and provide support for medical claims and utilization practices. Educate staff on medical reviews and participate in quality control activities.
remote, United StatesFull TimeJunior (<2 years)
UnitedHealth Group
Conduct coverage reviews based on member plan benefits and coverage review policies, rendering coverage determinations. Document clinical review findings and engage in peer-to-peer discussions with providers.
remote, United States$249k – $373k/yrFull TimeDirector
Machinify
Evaluate provider appeals and audit findings to determine correct DRG assignments. Review inpatient medical records and documentation for compliance with coding and billing guidelines. Prepare evidence-based rationales to support audit decisions.
remote, United States$100k – $115k/yrFull TimeMiddle (2-4 years)
Second Wave Delivery Systems
Review inpatient records for Patient Safety Indicators, mortality cases, and CMS Core Measures to identify documentation and coding opportunities. Recommend coding changes and manage physician queries to ensure accurate documentation.
remote, Las Vegas, NV, United States$95k – $120k/yrFull TimeSenior (5+ 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)
Acentra Health, LLC
Review medical records against criteria to determine appropriateness, ensuring accuracy and timeliness. Assess and manage daily workload, collaborating with supervisors on quality monitoring and improvement plans. Serve as a liaison for providers and address customer service issues.
remote, United States$57k – $71k/yrFull TimeMiddle (2-4 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)
Capitol Bridge, LLC.
Review and evaluate Workers’ Compensation Medicare Set-Aside (WCMSA) proposals, ensuring compliance with CMS guidelines. Determine future medical costs related to WC injuries and recommend WCMSA amounts to CMS. Ensure documentation requirements are met and implement CMS policy.
remote, United States$70k/yrFull TimeJunior (<2 years)
MedReview
Lead complex clinical validation reviews and provide final determinations on disputed findings. Manage physician-level appeals and conduct peer-to-peer discussions. Ensure compliance with CMS regulations and support quality assurance activities.
remote, United States$240k – $250k/yrFull TimeSenior (5+ 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)Acentra Health, LLC
Review medical records against criteria to determine appropriateness. Ensure accuracy and timeliness of reviews, manage daily workload, and monitor quality. Serve as a resource for nurse reviewers and liaise with providers for customer service issues.
remote, United States$57k – $79k/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$66k – $106k/yrFull TimeSenior (5+ years)
Humana
Conduct inpatient medical necessity reviews based on national guidelines and regulations. Analyze complex hospital cases and deliver utilization management determinations. Communicate with external providers to obtain clinical information and discuss review outcomes.
remote, United States$224k – $313k/yrFull TimeDirector
SmartLight Analytics
Analyze hospital claims and itemized bills for accuracy, identifying billing errors and DRG misassignments. Review high-cost claims to detect overpayments and negotiate adjustments with claims administrators. Prepare documentation to support claim adjustments and track disputes through resolution.
remote, Plano, TX, United StatesFull TimeSenior (5+ years)
AltaMed
Review authorization requests from various health plans, approving them per delegation responsibilities. Process denials using standard language and post recommendations in the authorization platform. Identify high-risk populations and refer them to case management programs.
remote, Montebello, CA, United States$249k – $311k/yrFull TimeJunior (<2 years)
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)
ChenMed
Conduct utilization management reviews for assigned territories, establishing 2-3 cases daily across multiple markets. Attend health plan and local team calls, and participate in weekly PCP and SNF meetings. Advise other physician reviewers and engage in process and quality improvement initiatives.
remote, United States$205k – $293k/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)
J29, Inc
Perform automated and complex reviews of Medicare Fee-for-Service claims, assessing payments according to Recovery Audit Contractors guidelines. Document findings, participate in dispute resolution, support quality assurance through audits, and maintain compliance with CMS standards.
remote, United States$71k – $81k/yrPart TimeSenior (5+ years)
Slingshot AI
Review anonymized conversations with Ash to assess its handling of key moments in mental health support. Provide clinical judgment on what Ash should do, potential pitfalls, and reasoning behind decisions.
remote, United States$202k – $282k/yrPart TimeLead / Manager
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)24-Mag
Review inpatient cases for clinical quality and appropriateness of care, ensuring documentation accuracy. Apply senior hospitalist judgement to complex scenarios and maintain high standards of accuracy.
remote, New York, NY, United States$141k – $202k/yrFull TimeSenior (5+ years)ChenMed
Oversee Utilization Management (UM) cases, establishing 2-3 cases daily across assigned markets. Attend health plan and local calls, and participate in weekly PCP and SNF meetings. Advise other physician reviewers and engage in process and quality improvement initiatives.
remote, United States$205k – $293k/yrFull TimeJunior (<2 years)
Wellbe Senior Medical
Conduct clinical documentation audits, evaluate medical records for compliance, and identify documentation risks. Deliver peer-level education to improve documentation practices and escalate complex cases to leadership.
remote, United StatesFull TimeMiddle (2-4 years)
Rainmakers Strategic Solutions
Review sponsor-submitted prior authorization (PA) and step therapy (ST) criteria for compliance with CMS guidance. Evaluate PA criteria fields for consistency with FDA-approved labeling and treatment guidelines.
remote, United StatesPart TimeSenior (5+ years)
Dane Street, LLC
Evaluate medical records, provide clinical summaries, engage in peer communications, and respond to client inquiries. Conduct thorough reviews of clinical cases to ensure high-quality healthcare assessments.
remote, United StatesFull TimeSenior (5+ years)
CoventBridge Integrity Systems
Conduct clinical reviews of medical records for fraud investigations and program integrity initiatives. Analyze claims history and provider files to detect fraudulent billing practices.
remote, OH, United States$78k – $85k/yrFull TimeMiddle (2-4 years)
Guidehouse
Review medical record documentation for coding and abstracting accuracy using ICD-10 CM/PCS and CPT coding systems. Conduct reviews via EMR and other methods, entering findings into proprietary tracking software. Respond to coder rebuttals in accordance with quality review policies and procedures.
remote, United States$65k – $108k/yrFull 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)Gainwell Technologies LLC
Coordinate and perform all 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$95k – $110k/yrFull TimeLead / ManagerGainwell 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)10,000,000+ more jobs available!
