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Flexible Medical Reviewer Jobs (NOW HIRING)

Managed Medical Review Organization

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... Flexible, remote contract opportunity. * Set your own schedule and case volume. * Collaborate with ...

MMRO

Orthopedic Spine Reviewer (Remote)

... medical necessity questions. Reviews are conducted remotely and do not require direct patient interaction. This role is ideal for physicians seeking flexible consulting opportunities that allow them ...

MMRO

Spine Surgery Reviewer (Remote)

... medical necessity questions. Reviews are conducted remotely and do not require direct patient interaction. This role is ideal for physicians seeking flexible consulting opportunities that allow them ...

MMRO

Spine Surgery Reviewer (Remote)

... medical necessity questions. Reviews are conducted remotely and do not require direct patient interaction. This role is ideal for physicians seeking flexible consulting opportunities that allow them ...

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Flexible Medical Reviewer information

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How much do flexible medical reviewer jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for flexible 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.

What is a flexible medical reviewer?

Flexible Medical Reviewers are healthcare professionals, often with clinical backgrounds, who assess medical records, claims, or research data on a flexible, often remote, schedule. Their primary role is to ensure that documentation is accurate, complete, and compliant with regulations and standards. They may work for insurance companies, healthcare providers, or research organizations, reviewing cases for medical necessity, coding accuracy, or quality assurance. The flexibility of the role allows these professionals to balance work with other commitments, making it appealing for those seeking non-traditional work hours.

How does a flexible medical reviewer typically collaborate with healthcare professionals and regulatory teams during the review process?

As a Flexible Medical Reviewer, you’ll regularly interact with clinical staff, regulatory affairs teams, and sometimes external stakeholders to ensure medical documents and reports meet compliance standards. Collaboration often involves clarifying clinical data, resolving discrepancies, and providing expert input on medical content. This cross-functional teamwork is essential for maintaining accuracy and upholding regulatory requirements, and often occurs through both virtual meetings and written communications. Being adaptable and an effective communicator are key in navigating the dynamic workflows and varied schedules typical of this flexible role.

What are the key skills and qualifications needed to thrive as a flexible medical reviewer, and why are they important?

To thrive as a Flexible Medical Reviewer, you typically need a healthcare degree (such as MD, PharmD, or RN) and thorough knowledge of medical terminology, pharmacology, and clinical guidelines. Familiarity with medical review software, electronic health records (EHRs), and regulatory compliance systems is crucial. Strong analytical thinking, attention to detail, and effective written communication are important soft skills for evaluating clinical information and preparing clear, accurate reports. These competencies ensure high-quality, compliant medical reviews that support patient safety and regulatory standards.

What is the difference between Flexible Medical Reviewer vs Medical Claims Reviewer?

AspectFlexible Medical ReviewerMedical Claims Reviewer
CredentialsMedical degree, licensure, certifications (e.g., CCM)Medical background, certifications often preferred
Work EnvironmentRemote or flexible settings, independent reviewTypically office-based, insurance or healthcare settings
Industry UsageHealthcare, insurance, telehealthInsurance companies, healthcare providers
Job FocusReview medical records, determine coverage eligibilityAssess claims for accuracy, compliance, and payment

Flexible Medical Reviewers and Medical Claims Reviewers both require medical knowledge and certifications. However, Flexible Medical Reviewers often work remotely, focusing on evaluating medical records and coverage decisions, while Medical Claims Reviewers typically work in insurance offices reviewing claims for accuracy and payment. The roles overlap in industry and credentials but differ in work environment and specific responsibilities.

What cities are hiring for Flexible Medical Reviewer jobs?

Cities with the most Flexible Medical Reviewer job openings:

What are the most commonly searched types of Medical Reviewer jobs?

The most popular types of Medical Reviewer jobs are:

What states have the most Flexible Medical Reviewer jobs?

States with the most job openings for Flexible Medical Reviewer jobs include:

Flexible Medical Reviewer jobs near you
Infographic showing various Flexible Medical Reviewer job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

RN Medical Reviewer, FEP

Blue Cross & Blue Shield of Mississippi

Flowood, MS • On-site

Other

Posted 4 days ago

Job description

RN Medical Reviewer, FEP

The RN Medical Reviewer, FEP is responsible for thorough clinical review of the Federal Employee Program pre-service requests and post-service claim review for medical and medical drug services. The RN Medical Reviewer, FEP is responsible for determining if the requested service is covered and medically necessary using established Service Benefit Plan and medical policy criteria and by requesting the necessary clinical documentation to make a determination. Once a determination is made, the RN Medical Reviewer, FEP must clearly document the clinical decision and rationale to provide instruction for claim adjudication. The RN Medical Reviewer, FEP is relied upon to identify member and provider utilization trends as well as identify members who may be eligible for Care Management intervention.

Job-Specific Requirements
  • Bachelor's degree in Nursing and RN licensure that is unrestricted in the state of Mississippi.
  • Master's degree in Nursing preferred.
  • Minimum 2 years of clinical experience.
  • Must possess excellent analytical and decision making skills to review and interpret complex claims and medical information to ensure claims are processed according to Service Benefit Plan provisions and Medical Policy.
  • Must be able to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.
  • Must be able to work a flexible schedule when required.
  • Must have above average PC skills and intermediate knowledge of Microsoft Office.

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.

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