Clinical Review Nurse

Job Description

Location: Dallas, TX

This is a full-time work-from-home position. Employees must be located in or within a commutable distance to the Dallas–Fort Worth area to attend required onsite training.

We are seeking a Clinical Review Nurse to support healthcare documentation and billing review activities within a remote clinical review environment. This role focuses on evaluating clinical and billing information to ensure services are accurately documented, appropriately reviewed, and aligned with regulatory and payer guidelines.

The ideal candidate brings strong acute care nursing experience, sound clinical judgment, and the ability to transition clinical expertise into an analytical, non-bedside role.

Key Responsibilities:

• Review clinical documentation and billing records to assess accuracy, completeness, and appropriateness.
• Analyze supporting medical records to support review outcomes and recommendations.
• Apply clinical knowledge related to surgical, procedural, and acute care services during review activities.
• Document findings and conclusions clearly within internal review systems.
• Adhere to quality, compliance, and productivity standards.
• Maintain confidentiality and compliance with HIPAA and applicable regulations.
• Collaborate with internal clinical and operational teams as needed.
• Perform additional duties to support departmental objectives.

Qualifications:

• Active, unrestricted Registered Nurse (RN) license in the state of employment.
• Associate Degree in Nursing (ADN) or higher required.
• Five or more years of clinical nursing experience in acute care settings such as ICU, ER, OR, or comparable environments.
• Prior experience in clinical review, utilization review, quality review, or related non-bedside nursing roles preferred.
• Strong analytical, organizational, and critical thinking skills.
• Ability to interpret medical documentation and apply clinical judgment outside of direct patient care.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office tools, including Excel, Outlook, and Teams.
• Ability to work independently in a remote environment while contributing within a team-based structure.

Schedule & Work Environment:

• Full-time, work-from-home position.
• Standard weekday schedule.
• Required onsite training in the Dallas–Fort Worth area.

Salary Range:

The salary range for this position is $55,000 – $90,000 annually (approximately $26.45 – $43.27 per hour), based on experience.

Interview Process:

Selected candidates will participate in a multi-step interview process, which will include a screening call with TalentLNX, followed by virtual interviews with clinical and operational stakeholders.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds, and we encourage all qualified candidates to apply for our job opportunities.