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Appeal Medical Reviewer Jobs (NOW HIRING)

Spectraforce Technologies

Appeals Nurse

Jacksonville, FL · On-site

$101K/yr

Review medical records for medical necessity, using approved criteria application, to make recommendations for MD on appeal medical necessity reviews. * Receive assignments electronically via company ...

New

Palmetto GBA, LLC

What You'll Do Perform medical claim reviews for one or more of the following: claims for medically complex services, services that require preauthorization/predetermination, requests for appeal or ...

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How much do appeal medical reviewer jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for appeal medical reviewer in the United States is $42.06, according to ZipRecruiter salary data. Most workers in this role earn between $22.84 and $54.09 per hour, depending on experience, location, and employer.

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Infographic showing various Appeal Medical Reviewer job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

Diagnostic Radiology- Medical Record Reviewer

Minneapolis, MN • On-site, Remote

Dane Street, LLC
Insurance Actuarial and Claim Adjusting Services • 51 - 200 employees
Learn more about Dane Street, LLCexternal

Full-time

Re-posted 28 days ago

Job description

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care.
MAJOR DUTIES AND RESPONSIBILITIES:
    • Reviews all medical records and addresses each question posed by the client, utilizing client-specific criteria or other nationally recognized evidence-based criteria
    • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
    • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
    • Provides copies of any criteria utilized in a review with the report promptly
    • Returns cases on or before the due date and time
    • Makes telephone calls as mandated by the state and/or client specifics
    • Maintains proper credentialing, state licenses, and any special certifications or requirements necessary to perform the job
    • Performs other duties as assigned, including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
    • Board certification required, active practice required

Please be aware that, in the interest of all parties, Dane Street won't conduct interviews via text or request checks from candidates for any reason, including the purchase of equipment.
Benefits
Benefits
  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

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