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Home Based Remote Medical Reviewer Jobs (NOW HIRING)

J29 Inc.

Medical Reviewer, Coder

Millersville, MD · On-site +1

$60K - $70K/yr

Remote *This role is a temporary position and that employment is expected to be for a limited ... Home Health/Hospice-to assess overpayments, underpayments, and proper payments as determined by ...

Empower AI Inc.

Medical Reviewer III (Medicare/DRG)

$28.38/hr

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Empower AI Inc.

Medical Reviewer III (Medicare/DRG)

$28.38/hr

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

Empower AI

Medical Reviewer III (Medicare/DME)

$28.38/hr

Perform comprehensive medical record and claims review to make payment determinations based on insurance coverage, coding, and utilization of services and practice guidelines for Medicare DME.

Empower AI Inc.

Medical Reviewer III (Medicare/DRG)

$28.38/hr

Perform comprehensive medical record and claims review to make payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DRG.

MMRO

Orthopedic Spine Reviewer (Remote)

... based medical peer reviews and disability evaluations. For more than 30 years, MMRO has partnered ... Why Partner with MMRO? * 100% remote independent contractor opportunity * Flexible scheduling with ...

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Home Based Remote Medical Reviewer information

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$11

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$100

How much do home based remote medical reviewer jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for home based remote 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 home based remote medical reviewer?

Home Based Remote Medical Reviewers are healthcare professionals, often nurses or physicians, who evaluate medical records, treatment plans, or claims from a remote location, typically their home. Their primary role is to ensure that medical services provided to patients meet regulatory, clinical, and insurance standards. They assess documentation for accuracy, completeness, and compliance, and may also determine the medical necessity of procedures or treatments. This position allows for flexible scheduling and eliminates the need for daily commuting, making it a popular option for qualified professionals seeking work-life balance.

How do home based remote medical reviewers collaborate with clinical teams and ensure accurate communication while working remotely?

Home Based Remote Medical Reviewers often collaborate with clinical teams through secure digital platforms, such as electronic health record systems and team communication tools like Slack or Microsoft Teams. Regular virtual meetings and clear documentation practices help maintain alignment and support timely case reviews. Effective reviewers are proactive communicators, ensuring that questions or concerns about patient records are addressed promptly. This remote structure allows for flexibility but requires strong organizational skills and attention to detail to ensure accuracy and compliance with healthcare regulations.

What are the key skills and qualifications needed to thrive as a home based remote medical reviewer?

To excel as a Home Based Remote Medical Reviewer, a strong background in healthcare or life sciences, often supported by a medical degree, nursing degree, or relevant certification, is essential. Familiarity with medical terminology, clinical documentation systems, and review platforms like electronic health records (EHRs) or specialized medical review software is typically required. Excellent attention to detail, analytical thinking, and strong written communication skills set top performers apart in this role. These skills ensure accurate, compliant medical record evaluations and support effective decision-making in remote healthcare environments.

What is the difference between Home Based Remote Medical Reviewer vs Home Based Remote Medical Coder?

AspectHome Based Remote Medical ReviewerHome Based Remote Medical Coder
Required CredentialsMedical degree, licensure, certifications (e.g., AAPC, AHIMA)Certification in coding (e.g., CPC, CCS), training in medical coding
Work EnvironmentRemote, independent review of medical recordsRemote, analyzing and coding medical documentation
Employer & Industry UsageInsurance companies, third-party administratorsHospitals, clinics, insurance companies
Common Search & ComparisonYesYes

Both roles are remote healthcare positions requiring specialized certifications. Medical reviewers evaluate medical records for claims and coverage, while medical coders translate medical documentation into standardized codes. Although they share a remote work environment and industry usage, their core responsibilities and credentials differ significantly.

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Home Based Remote Medical Reviewer jobs near you
Infographic showing various Home Based Remote Medical Reviewer job openings in the United States as of August 2026, with employment types broken down into 50% Part Time, and 50% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

Medical Reviewer (Laboratory Specialist) - Remote CA

Gainwell Technologies

West Sacramento, CA • On-site, Remote

$50K - $60K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 17 days ago

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

130th of 247 rated software companies

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
Gainwell Technologies is seeking a Medical Reviewer (Laboratory Specialist) to provide laboratory subject-matter expertise supporting Medical Review Services for California healthcare programs. In this role, you will review laboratory-related claims, Treatment Authorization Requests (TARs), orders, and supporting documentation to help ensure laboratory services meet applicable coverage, medical necessity, and program requirements.
Your role in our mission
  • Review laboratory-related claims, Treatment Authorization Requests (TARs), orders, and supporting documentation.
  • Evaluate laboratory services based on applicable medical policies, coverage requirements, and program guidelines.
  • Apply laboratory expertise when reviewing the appropriateness of requested or billed laboratory services.
  • Support claim adjudication and medical review activities involving laboratory testing.
  • Review supporting documentation for completeness and alignment with applicable program requirements.
  • Document review findings, decisions, and supporting rationale accurately and timely.
  • Identify documentation, billing, or coverage issues requiring additional review or clarification.
  • Collaborate with clinical, operational, provider-facing, and other Medical Review Services teams to resolve laboratory review questions.
  • Maintain knowledge of applicable laboratory practices, medical policies, coverage requirements, and healthcare program guidelines.
  • Meet established quality, accuracy, productivity, and turnaround-time expectations.

What we're looking for
  • Minimum of two (2) years of experience as a laboratory technician.
  • High school diploma or equivalent.
  • Completion of a Medical Laboratory Technician program from an accredited medical laboratory technician school.
  • Knowledge of laboratory procedures, terminology, testing, and documentation.
  • Ability to interpret laboratory-related records, orders, claims, and supporting documentation.
  • Strong analytical, written, and verbal communication skills.
  • Ability to work independently while collaborating effectively with clinical, operational, and cross-functional teams.

What you should expect in this role
  • Full-time position.
  • Remote work environment.
  • Monday through Friday work schedule.
  • Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
  • Spend the majority of your day reviewing laboratory-related claims, authorization requests, orders, medical documentation, and supporting records.
  • Work independently while collaborating with physicians, nurses, other clinical specialists, operations teams, providers, and business partners.
  • Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
  • Maintain all professional certifications and credentials required for the position in active and good-standing status, as applicable.
  • Maintain knowledge of applicable medical policies, laboratory practices, coverage requirements, and regulatory guidelines.
  • Meet established quality, accuracy, productivity, and turnaround-time expectations.
  • Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.
  • Travel requirement: 0-10%.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis
#LI-REMOTE
#LI-MA1
The pay range for this position is $50,000 - $60,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

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Benefits

Hours and flexibility

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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