Remote Clinical Validation RN — Elevate Patient Documentation

MedicalVirtual; United States; Remote; USD 80,000 - 110,000; Full time

Job summary

MedicalVirtual is seeking a Clinical Validation RN to review medical records and confirm diagnoses reflect patient condition, treatment, and acuity. You will work with CDI, physicians, coding, HIM, and QA teams to ensure accurate documentation and compliant clarification queries.

You will maintain HIPAA compliance, stay current with ICD-10-CM/PCS guidelines, and support reimbursement and quality reporting initiatives while meeting productivity goals in a remote, national scope.

Qualifications

• Active RN license in the applicable state(s).
• Associate degree required; BSN preferred.
• 3+ years of clinical nursing experience preferred (acute-care setting).
• CCDS, CDIP, or related clinical documentation/coding certification preferred.
• Inpatient coding/ICD-10-CM/PCS knowledge.
• Familiarity with CMS payer requirements and regulatory standards.

Responsibilities

• Review inpatient and outpatient records to validate that diagnoses are clinically supported.
• Identify documentation gaps or inconsistencies and request clarifications.
• Develop compliant, non-leading clinical documentation clarification queries.
• Collaborate with CDI, physicians, coders, HIM, and care teams.
• Apply clinical knowledge and coding guidelines to support validation decisions.
• Maintain HIPAA confidentiality and timely documentation of activities.

Skills

Clinical judgment

Attention to detail

Documentation & coding knowledge

Effective communication

Query quality

Analytical ability

Compliance focus

Productivity & organization

Continuous learning

Teamwork

Education

Associate degree

RN license in applicable state(s)

BSN preferred

Tools

Electronic Medical Records (EMR)

Microsoft Office

Job description

MedicalVirtual is seeking a Clinical Validation RN to review medical records and confirm diagnoses reflect patient condition, treatment, and acuity. You will work with CDI, physicians, coding, HIM, and QA teams to ensure accurate documentation and compliant clarification queries.

You will maintain HIPAA compliance, stay current with ICD-10-CM/PCS guidelines, and support reimbursement and quality reporting initiatives while meeting productivity goals in a remote, national scope.