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Clinical Reviewer Jobs (NOW HIRING)

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Clinical Reviewer information

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$24

$35

$46

How much do clinical reviewer jobs pay per hour?

As of Jun 8, 2026, the average hourly pay for clinical reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

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 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 are the key skills and qualifications needed to thrive as a Clinical Reviewer, and why are they important?

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 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.

What are clinical reviewers?

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 cities are hiring for Clinical Reviewer jobs? Cities with the most Clinical Reviewer job openings:
What are the most commonly searched types of Clinical Reviewer jobs? The most popular types of Clinical Reviewer jobs are:
Who are the top companies hiring for Clinical Reviewer jobs? The top employers for Clinical Reviewer jobs are:
What states have the most Clinical Reviewer jobs? States with the most job openings for Clinical Reviewer jobs include:
RN Clinical Reviewer (Proofer)

$45/hr

Full-time

Medical

Posted 17 days ago


Job description

(Only QUALIFIED Healthcare Professionals accepted) Clinical Assistant and/or Medical Assistant - RN Clinical Reviewer (Proofer) - Jericho, NY (#25289)
Location: Jericho, NY
Employment Type: Full-time, Temp-to-Hire
Hourly Rate: $45|hr
About Greenlife Healthcare Staffing:
Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals.
Position Overview:
Greenlife Healthcare Staffing is seeking a meticulous Clinical Editor|Proofer Registered Nurse to ensure the accuracy, clarity, and compliance of NYS Dispute Resolution and External Review determinations. This role combines clinical expertise with editorial precision to produce error-free case documents, thereby improving team performance through error tracking and retraining.
Why Join Us?
~ Competitive Compensation: Earn $45 per hour
~ Comprehensive Benefits:
~ Paid Sick Time
~ Health insurance
~ Benefits from Paychex, such as Payactiv
~ GLHS is a great company to work for: 93% retention of employees 2 years+, excellent reviews, great company culture
~ Work Schedule: Full-time (5 days per week), Temp-to-Hire position
~ Professional Growth: Collaborative environment enhancing experience in clinical review and medical editing
~ Impactful Work: Ensure accuracy and integrity of state-level healthcare dispute resolutions
Qualifications:
~ Education: BSN or graduate of an approved RN program; post-graduate studies showing strong writing|editing|proofing proficiency required
~ Licensure: Active NY State RN license
~ Experience:
~ Minimum 2 years acute care experience (medicine|surgery or special care units preferred)
~ 13 years acute care utilization review experience
~ Technical Skills: EMR experience including coding, charting, and quality review
~ Soft Skills: Exceptional attention to detail, strong writing|editing ability, collaboration skills; writing sample or publication required
Key Responsibilities:
~ Review pre-final dispute determinations using checklist tools
~ Make clinical and mathematical edits using provided case documentation
~ Consult with team members and supervisors to refine final outcomes
~ Perform final checks: content, references, grammar, spelling, punctuation
~ Track and trend errors, analyze areas for improvement, and provide feedback
~ Offer technical assistance and participate in staff huddles
~ Perform other related duties as needed

National Coalition Of Healthcare Recruiters logo

About National Coalition Of Healthcare Recruiters

Sourced by ZipRecruiter

The National Coalition of Healthcare Recruiters (NCHCR) is an established company based in Blennerhassett, West Virginia that operates within the healthcare industry. With a commitment to maintaining high standards of professionalism, they offer specialized recruitment services to healthcare professionals and institutions across the country. Operating as a coalition, they implement a powerful networking platform to connect employers and job seekers in the healthcare sector. The organization’s mission revolves around ensuring that healthcare services across the nation have access to the best talent available and potential candidates can find rewarding opportunities.

Industry

Recruiting and staffing services

Company size

1 - 10 Employees

Headquarters location

Blennerhassett, WV, US

Year founded

2005

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