What is a medical review nurse job?
Medical review nurse jobs are essential roles in the healthcare industry that focus on reviewing and assessing medical records and patient data for accuracy, completeness, and consistency. These professionals ensure that patient care plans are appropriate and meet medical standards. They also collaborate with healthcare providers to ensure that medical treatments and procedures are in line with best practices and medical guidelines. Medical review nurses are typically employed in hospitals, clinics, insurance companies, and other healthcare settings.
What do medical review nurses usually do in this position?
Medical review nurses are responsible for reviewing medical records, patient data, and other documentation to ensure that the information is accurate, complete, and consistent. They evaluate and assess the medical history of patients, including laboratory results, medication usage, and diagnostic tests. Medical review nurses also collaborate with healthcare providers to develop and implement care plans for patients to ensure that they receive the appropriate treatment and care.
Top 5 skills for the medical review nurse position
- Strong analytical and critical thinking skills
- Excellent communication and interpersonal skills
- Attention to detail and accuracy
- Ability to work independently and in a team environment
- Strong knowledge of medical terminology and procedures
How to become a medical review nurse specialist
To become a medical review nurse specialist, you typically need a Bachelor of Science in Nursing (BSN) degree, as well as a Registered Nurse (RN) license. Many employers also prefer candidates with a Master of Science in Nursing (MSN) degree. You may also need to complete additional training and certification in medical review and case management.
Average salary for medical review nurses
According to the Bureau of Labor Statistics, the median annual salary for registered nurses was $75,330 in May 2020. However, salaries for medical review nurses can vary depending on location, experience, and employer. Some medical review nurse positions may offer additional compensation and benefits, such as bonuses, health insurance, and retirement plans.
Roles and types of medical review nurse jobs
Medical review nurse jobs can vary depending on the employer and type of healthcare setting. Some common roles and types of medical review nurse jobs include:
- Utilization review nurse
- Case manager nurse
- Quality improvement nurse
- Medical claims reviewer
- Insurance underwriter nurse
Locations with the most popular medical review nurse jobs in the USA
Medical review nurse jobs are in high demand across the United States, with many opportunities available in both urban and rural areas. Some of the top locations for medical review nurse jobs include:
- California
- Texas
- Florida
- New York
- Pennsylvania
What are the typical tools used in medical review nurse jobs?
Medical review nurses use a variety of tools and software to review and assess medical records and patient data. Some common tools include electronic medical record (EMR) systems, health information management (HIM) software, and case management systems. Medical review nurses may also use medical coding software to assign codes to medical diagnoses and treatments for insurance reimbursement purposes.
In conclusion
Medical review nurse jobs are crucial roles in the healthcare industry that ensure patient care plans are appropriate and meet medical standards. These professionals use their skills and knowledge to review and assess medical records and collaborate with healthcare providers to develop and implement care plans for patients. A career as a medical review nurse specialist requires a Bachelor of Science in Nursing (BSN) degree, as well as a Registered Nurse (RN) license, and additional training and certification in medical review and case management. Salaries for medical review nurses can vary depending on location, experience, and employer, but the demand for these professionals is high across the United States.