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Clinical Reviewer Jobs in Kansas (NOW HIRING)

League Inc.

Clinical review - validating that League's capabilities, programs, and content reflect current evidence and standards of care. * Other projects as needed - from time to time, additional projects may ...

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How much do clinical reviewer jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for clinical reviewer in Kansas is $32.03, according to ZipRecruiter salary data. Most workers in this role earn between $27.88 and $36.01 per hour, depending on experience, location, and employer.

What is a clinical reviewer?

Clinical reviewers are professionals who evaluate medical records, clinical data, or healthcare documentation to ensure accuracy, compliance, and quality of care. They may work in settings such as hospitals, insurance companies, or regulatory agencies to review cases for appropriateness of care, adherence to clinical guidelines, or for billing and coding accuracy. Clinical reviewers often have backgrounds in nursing, medicine, or another healthcare field and use their expertise to make informed assessments. Their work is critical for improving patient outcomes, supporting proper reimbursement, and maintaining regulatory standards.

What does a clinical reviewer do?

A clinical reviewer monitors healthcare documents to ensure compliance before submitting to insurance companies. You handle the daily responsibilities of checking medical records for appropriate criteria and providing the proper documentation. You collaborate with providers to ensure all information is accurate. Your duties are also to review requests for services, research and gather further information when necessary, perform an information audit, and evaluate procedures for approval. You also record, analyze, and report data elements that could help improve the quality of care of a patient.

What skills are required for a clinical reviewer?

To thrive as a Clinical Reviewer, you need a strong background in healthcare or life sciences, often supported by a relevant degree and experience in clinical settings. Familiarity with medical terminology, regulatory requirements, and systems such as electronic medical records (EMRs) or clinical trial management software is typical. Attention to detail, analytical thinking, and effective written communication are standout soft skills for this role. These skills ensure accurate evaluation of clinical data, compliance with standards, and clear reporting, which are critical for patient safety and regulatory approval.

What are some common challenges clinical reviewers face when evaluating medical records, and how can they be addressed?

Clinical Reviewers often encounter challenges such as incomplete documentation, inconsistent terminology, and tight deadlines when evaluating medical records. To overcome these issues, it's important to develop strong attention to detail, stay current with medical coding standards, and communicate effectively with healthcare providers to clarify ambiguities. Collaborating closely with clinical teams and leveraging electronic health record (EHR) systems can also help streamline the review process and ensure accuracy.

What is the difference between Clinical Reviewer vs Medical Reviewer?

AspectClinical ReviewerMedical Reviewer
Required CredentialsRN, LPN, or other healthcare licenses; sometimes certifications in case management or clinical reviewMD or DO; medical license; often board-certified in a specialty
Work EnvironmentInsurance companies, healthcare organizations, or government agencies; reviewing medical records and claimsHospitals, clinics, insurance companies; evaluating medical records and providing expert opinions
Employer & Industry UsagePrimarily in insurance and healthcare administrationPrimarily in insurance, healthcare, and legal settings

Both Clinical Reviewers and Medical Reviewers assess medical information, but Clinical Reviewers typically hold nursing or allied health credentials and focus on case management and claims review. Medical Reviewers are licensed physicians who provide expert medical opinions. The roles often overlap in insurance and healthcare industries, but their credentials and scope of practice differ.

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Clinical Reviewer jobs near you
Infographic showing various Clinical Reviewer job openings in Kansas as of August 2026, with employment types broken down into 73% Full Time, and 27% Part Time. Highlights an 93% In-person, and 7% Hybrid job distribution, with an average salary of $66,627 per year, or $32 per hour.

Insurance Reviewer-Clinical

The US Oncology Network

Wichita, KS • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago

US Oncology rating

7.1

Company rating: 7.1 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

379th of 895 rated healthcare providers

Job description

Overview
The Cancer Center of Kansas (CCK) is seeking a full-time, on-site Insurance Reviewer to join our team in our Wichita, KS offices. The typical work week is Monday through Friday, 8:30 AM - 5:00 PM with no major holidays, no on-call and no weekends.
As part of The US Oncology Network and with over 40 years being established in Kansas, CCK delivers quality, personalized cancer care to communities across the state. Our physicians and staff treat patients in over 18 locations throughout the state. Our management and physician teams continue to be recognized in our communities for Excellence in Healthcare! With our mission in mind, we value each and every employee for their life-saving expertise and the role they play in making our patients' lives as easy and comfortable as possible. Our employees are our most valuable resource. They help us create and continue to deliver on our mission.
In CCK's partnership with the US Oncology Network, one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America and supported by McKesson Corporation, we are able to extend an extremely competitive offering of benefits to employees, including:
  • Medical Health Care

  • Dental Care

  • Vision Plan

  • 401-K with a matching component

  • Life Insurance

  • Short-term and Long-term disability

  • FSA and HSA

  • Legal Insurance

  • Competitive Paid Time Off Plan

  • Wellness & Perks Programs

What does this position entail?
This role, under general supervision, reviews chemotherapy regimens and orders in accordance to reimbursement guidelines and standard of care adherence. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
Responsibilities
The essential duties and responsibilities of this position are:
  • Obtains prior authorization for scans, labs, subsequent chemotherapy visits or any other service as required.

  • Maintains a professional working relationship with co-workers, insurance companies and referring doctor offices.

  • Assists in receiving and reviewing orders from CCK providers to analyze if necessary to, and then when necessary, obtain prior-authorization.

  • Receives and reviews clinical documents within the electronic medical record ("EMR") in order to meet requirements for obtaining the authorization.

  • Services responsible for obtaining prior authorizations for may include radiology, laboratory, chemotherapy and injections.

  • Contacts referring physicians and facilities to obtain referrals for all services scheduled at CCK.

  • Provides clinical information to insurance companies and case managers as needed.

  • Coordinates peer to peer calls between physicians and insurance companies.

  • Assists in maintaining up to date information on insurance requirements for all authorization needs per payer.

  • Uploads and attaches authorizations and referrals to the practice management system ("PMS") and EMR as needed.

  • Contacts insurance companies through effectively navigating company websites, managed care portals and through methods such as phone and fax in order to complete prior authorization information requests for ordered services.

  • Timely and accurate entry of information in the PMS and EMR.

  • Follows the status of authorizations and referrals to ensure timely receipt.

  • Ability to multi-task and communicate through various mediums.

  • Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization.

  • Remains current on all compliance requirements and in part, demonstrates knowledge of Adheres to confidentiality, state, federal, and HIPPA (Health Insurance Portability and Accountability Act) laws and guidelines with regards to patient's records and information.

  • Attends required, applicable meetings.

  • Remains current on all compliance requirements.

  • Ensures all applicable policies and procedures of the company and Network are followed.

  • Other duties as requested or assigned including coverage within the department.

  • Performs other tasks as reasonably requested by a provider or member of the Management Team, as applicable to the role.

Supervisory Responsibilities:
  • None.

Qualifications
The ideal candidate for the position will have the following qualifications:
Minimum Qualifications:
  • High school degree or equivalent.

  • Associates degree in Healthcare or Business-related preferred.

  • Minimum three (3) years medical insurance verification and authorization required.

Competencies:
  • Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.

  • Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.

  • Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.

  • Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.

  • Demonstrates Team-Oriented Characteristics: Fosters a positive and productive team environment by working effectively with others and offering help when able.

  • Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.

Physical Demands of the Job:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
Work Environment:
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

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