Review Nurse

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct clinical medical record reviews and abstraction to support healthcare quality, compliance, and project needs.

• Consistently apply established review criteria, evidence-based clinical guidelines, coding specifications, and measure specifications.

• Clearly, objectively, and thoroughly document review findings.

• Evaluate documentation related to the treatment and management of physical health conditions utilizing clinical nursing expertise.

• Assist in medical record reviews, clinical auditing, or other similar healthcare review activities.

• Identify discrepancies or questions in documentation and escalate them through the appropriate project protocol.

• Ensure accuracy, consistency, confidentiality, and data integrity while managing medical records and review results.

• Meet quality standards, productivity expectations, priorities, and project deadlines.

• Acquire knowledge and utilize assigned systems, databases, and review tools.

• Operate independently with minimal supervision and seek clarification when requirements are ambiguous.

• Organize and prioritize multiple tasks, deadlines, and competing or overlapping projects.

• Balance record review tasks with operational or project coordination responsibilities.

• Communicate review status, inquiries, and findings with project leadership and team members.

• Engage in training and quality review initiatives.

• Maintain necessary professional licensure and stay updated with relevant clinical and healthcare review practices.

• Perform related duties and special projects that support business and operational requirements.

⛳️ Requirements

• Valid, unrestricted Registered Nurse (RN) license.

• Bachelor of Science in Nursing (BSN) or a higher degree.

• At least 3 years of clinical nursing experience in a medical, surgical, acute care, ambulatory care, specialty care, long-term care, or similar healthcare treatment environment involving the assessment, treatment, and management of physical health conditions.

• Minimum of 2 years of experience in medical record review, clinical auditing, or similar healthcare review functions.

• Technical proficiency and willingness to learn new systems, databases, and review tools.

• Strong organizational abilities and capacity to manage multiple priorities and deadlines.

• Ability to work independently with minimal oversight.

• Capability to communicate and document findings in a clear, accurate, and objective manner.

• Experience in balancing review duties with operational or project coordination tasks.

🏝️ Benefits

• Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.

• EEO Employer of Veterans protected under Section 4212.

• Assistance in completing the employment application process for applicants with special needs.