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Clinical Insurance Reviewer Jobs in California (NOW HIRING)

Onos

Clinical Quality Reviewer - BCBA

San Francisco, CA · On-site

$110K - $140K/yr

Clinical Quality Reviewer - BCBA About Onos Health Onos Health's mission is simple but ambitious ... Medical, dental, and vision insurance * Pre-tax commuter benefits * 401(k) * Significant equity as ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all ...

Astiva Health, Inc

UM Nurse Reviewer

Orange, CA · On-site

Apply clinical knowledge when processing deferrals and denials, supported by regulatory guidelines ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

Apply clinical knowledge when processing deferrals and denials, supported by regulatory guidelines ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

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All JobsClinical Insurance Reviewer JobsClinical Insurance Reviewer Jobs in California

Clinical Insurance Reviewer information

See California salary details

$23

$35

$45

How much do clinical insurance reviewer jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for clinical insurance reviewer in California is $35.45, according to ZipRecruiter salary data. Most workers in this role earn between $30.82 and $39.86 per hour, depending on experience, location, and employer.

What is a clinical insurance reviewer?

A Clinical Insurance Reviewer evaluates medical claims to ensure they meet insurance policies and clinical guidelines. They review patient records, verify medical necessity, and determine coverage eligibility. This role requires knowledge of medical terminology, coding, and insurance regulations. Clinical Insurance Reviewers help prevent fraud, ensure compliance, and support fair reimbursement for healthcare providers and patients.

What are the typical daily responsibilities of a clinical insurance reviewer?

Clinical Insurance Reviewers spend much of their day reviewing medical records and patient documentation to determine the medical necessity and appropriateness of treatments for insurance coverage. They assess claims against clinical guidelines, communicate their findings with healthcare providers or case managers, and may also participate in peer-to-peer reviews or appeals. Most positions involve working closely with other reviewers, physicians, and administrative staff, either remotely or in a collaborative office setting. This role requires strong organizational skills as well as the ability to manage multiple case reviews and deadlines simultaneously.

What are the key skills and qualifications needed to thrive as a clinical insurance reviewer?

To thrive as a Clinical Insurance Reviewer, you need a solid understanding of clinical practices, medical terminology, and insurance guidelines, often supported by a background in nursing or other healthcare professions. Familiarity with electronic medical records (EMRs), claims management systems, and utilization review software is highly valuable, and certifications such as Certified Professional in Healthcare Quality (CPHQ) can be advantageous. Strong analytical thinking, attention to detail, and effective communication skills set top performers apart in this role. These skills are crucial for accurately evaluating medical claims, ensuring compliance, and facilitating clear communication between healthcare providers and insurance companies.

What are popular job titles related to Clinical Insurance Reviewer jobs in California?

For Clinical Insurance Reviewer jobs in California, the most frequently searched job titles are:

What job categories do people searching Clinical Insurance Reviewer jobs in California look for?

The top searched job categories for Clinical Insurance Reviewer jobs in California are:

What cities in California are hiring for Clinical Insurance Reviewer jobs?

Cities in California with the most Clinical Insurance Reviewer job openings:

Clinical Insurance Reviewer jobs near you
Infographic showing various Clinical Insurance Reviewer job openings in California as of August 2026, with employment types broken down into 75% Full Time, 19% Part Time, and 6% Contract. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $73,729 per year, or $35.4 per hour.

Utilization Review Liaison

Washington Hospital

Fremont, CA • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Salary Range: $32.35 - $43.63 + applicable differentials 

Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all Case Management staff, Business Office, Patient Access, and along with the Hospital’s Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management. 

Provides office and referral management support services; assists the Utilization Review Team in obtaining medical records, documenting case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed.

Continue to learn about clinical programs, processes, and changes

May also perform office support functions as required

In addition to performing the essential functions listed below, may also be assigned other duties as required.