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Medical Case Reviewer Jobs (NOW HIRING)

French Consulting

Medical Case Manager

Warner Robins, GA · On-site

$60 - $90/hr

You'll review medical case files, track them through adjudication, and keep reserve units informed at every step. What You'll Do * Update case status in AIMWTS, ECT, PEPP, and other systems of record ...

Crawford and Company

Medical Case Manager

Portland, OR · On-site

$53K - $98K/yr

Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by ...

Crawford and Company

Medical Case Manager

Orlando, FL · On-site

$53K - $98K/yr

Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by ...

Solomon Page

Medical Case Review Physician

Warren, NJ · On-site

$140 - $150/hr

Perform medical review and evaluation of individual case safety reports (ICSRs) for both investigational and marketed products, including assessment of seriousness, causality, expectedness ...

Crawford and Company

Medical Case Manager

Columbia, SC · On-site

$53K - $98K/yr

Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by ...

Crawford and Company

Medical Case Manager

Boca Raton, FL · On-site

$53K - $98K/yr

Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by ...

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Medical Case Reviewer information

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$15

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How much do medical case reviewer jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for medical case reviewer in the United States is $27.89, according to ZipRecruiter salary data. Most workers in this role earn between $21.15 and $31.25 per hour, depending on experience, location, and employer.

What is a medical case reviewer?

Medical Case Reviewers are healthcare professionals who assess and evaluate medical records, cases, or claims to ensure they meet regulatory, clinical, and organizational standards. They analyze documentation for completeness, accuracy, and compliance with policies and guidelines. Their work is crucial in healthcare settings, insurance companies, or clinical research organizations to support quality assurance and proper adjudication of medical cases. Medical Case Reviewers often have backgrounds in nursing, medicine, or related health fields, and they play a key role in maintaining the integrity of patient care and data.

What are the key skills and qualifications needed to thrive as a medical case reviewer?

To thrive as a Medical Case Reviewer, you need a solid background in healthcare or life sciences, often supported by a clinical degree and experience in medical record analysis. Familiarity with case management software, regulatory guidelines, and electronic health records (EHRs) is typically required. Attention to detail, critical thinking, and strong written communication are essential soft skills for evaluating cases and preparing comprehensive reports. These competencies are crucial for ensuring accurate case assessments, maintaining compliance, and supporting patient safety.

What are some common challenges faced by medical case reviewers in balancing accuracy with productivity?

Medical Case Reviewers often navigate the challenge of thoroughly evaluating complex clinical documentation while meeting productivity targets. Balancing the need for precise, evidence-based assessments with efficiency requires strong organizational skills and up-to-date knowledge of medical guidelines. Additionally, reviewers may encounter incomplete or ambiguous information, necessitating effective communication with healthcare providers to clarify details. Adapting to varying case types and regulatory requirements also adds complexity, making adaptability and continuous learning essential for success.

What is the difference between Medical Case Reviewer vs Medical Claims Adjuster?

AspectMedical Case ReviewerMedical Claims Adjuster
Required CredentialsMedical degree or nursing license, certifications in case reviewInsurance licensing, sometimes medical background
Work EnvironmentHealthcare facilities, insurance companies, remoteInsurance companies, claims departments, remote
Industry UsageHealthcare, insurance, legalInsurance, healthcare
Common Search/ComparisonYesYes

Medical Case Reviewers evaluate medical records to determine coverage and treatment necessity, often requiring medical credentials. Medical Claims Adjusters handle insurance claims, assessing damages and coverage, sometimes with medical knowledge. While both roles involve insurance and healthcare, Medical Case Reviewers focus on clinical review, whereas Claims Adjusters focus on claims processing and settlement.

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What cities are hiring for Medical Case Reviewer jobs?

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What states have the most Medical Case Reviewer jobs?

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

Medical Case Reviewer jobs near you
Infographic showing various Medical Case Reviewer job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $58,003 per year, or $27.9 per hour.

Medical Case Manager Lead

H&H Continuous Improvement & Services

Warner Robins, GA • On-site

$95K - $110K/yr

Full-time

Re-posted 6 days ago

Key responsibilities

  • Act as lead medical case manager ensuring team adherence to clinical standards, regulations, and program requirements.

  • Provide updates on team cases, including aeromedical waivers and physical standards waivers, and ensure accurate documentation in electronic systems.

  • Monitor case management workflows, conduct case reviews and audits, and support training and professional development for team members.

Job description

About the Role:
Normal hours are 0800 to 1600 (EST) Monday through Friday excluding Federal Holidays. Core hours (must be present) are 0900 to 1500 (EST). Flex time is permitted to meet workload requirements. This position is contingent upon contract award. 
Must be a US citizen and able to obtain a clearance to work on a military base and access medical information.
H&H Continuous Improvement & Services is looking for an experienced Medical Case Manager Lead to be the senior small team lead over 3 other Medical Case Managers at Robins Air Force Base, GA.  If you're passionate about supporting our military and ensuring that our military members are mission ready, we want to hear from you!
Responsibilities:
  • Act as lead medical case manager ensuring the medical case managers who report to you adhere to clinical standards, published regulations, and program requirements.
  • Provide updates on the status of your team’s aeromedical waivers, physical standards waivers, and operational and deployed member cases to the Medical Case Manager Supervisor and ensure packages are complete and entered accurately into required electronic systems.
  • Collaborate with units, military treatment facilities (MTF), and military and civilian healthcare providers to facilitate evaluations as required.
  • Monitor case management workflows, productivity metrics, and quality improvement initiatives for your team.
  • Conduct regular case reviews and audits to ensure compliance with regulatory and contractual requirements for your team.
  • Serve as a liaison between service members and units.
  • Assist the Medical Case Manager Supervisor with training, performance evaluations, and professional development guidance to case management staff.
Requirements:
  • Active RN, LCSW, or equivalent clinical license in good standing.
  • Minimum of 3–5 years of case management experience preferably in an MTF.
  • Certification in Case Management (CCM) preferred.
  • Must be capable of working independently with strong time-management and prioritization skills.
  • Must be proficient in reading, writing, speaking, and understanding the English language to effectively communicate applicable technical subject matter to management, providers, and service members.
  • Must possess exceptional customer service skills.
  • Must possess demonstrated experience processing and managing physical exams and medical standards in military medical environments or through equivalent civilian aeromedical, occupational health, or disability evaluation system environments.
  • Must demonstrate a high level of proficiency with or possess the ability to rapidly acquire proficiency in Air Force and DoD medical systems, including the Aeromedical Information Management Waiver Tracking System (AIMWTS), Physical Examination Processing Program (PEPP), Periodic Health Assessment (PHA) programs, Joint Legacy Viewer (JLV), and Management Internal Control Toolset (MICT). Familiarity with these systems and the aeromedical waiver process is a differentiator.
  • Must demonstrate a high level of knowledge or rapidly master these requirements within 30 days of hiring regarding medical standards for retention, flying classes, Line of Duty (LOD) determinations, and special operational duty for the USAF. 
  • Must be proficient in utilizing the Aeromedical Waiver Guide (AMWG) and the Medical Standards Directory (MSD) or rapidly master these requirements within 30 days of hiring.
  • Must possess basic knowledge of anatomy, physiology, disorders of human body systems, and emergency medical care procedures. Must possess knowledge of medical terminology and International Classification of Diseases (ICD-10) coding and possess the ability to use medical terminology accurately when documenting cases.
  • Must possess excellent oral and written communication skills and project management experience (self-managing medical cases from intake to resolution/discharge).
  • Must possess the ability to translate and communicate complex medical/administrative instructions to service members at the member’s comprehension level.
  • Must be highly proficient with Adobe and the Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint). 
  • Must possess proficient typing skills utilizing standard English keyboards with 10-key pads.
About Us:
H&H Continuous Improvement & Services focuses on service excellence and quality by building high performing teams that embrace continuous improvement and learning. Our team members support each other and work together to accomplish each task to meet or exceed our client’s expectations.