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Medical Case Reviewer Jobs (NOW HIRING)

DAWSON

LPN CASE REVIEWER

Pinellas Park, FL · On-site

$22.50 - $30.50/hr

In this role, you will provide the services of Medical Case Management in support of Individual ... review process of temporary or permanent P3/4 profiles. * Contact Soldiers to obtain medical ...

MyFlorida

MEDICAL CASE MANAGER - 67073539

Tampa, FL · Hybrid

$2K - $3K/wk

Primary duties include, but are not limited to, clinical oversight of medical case reviews, medication administration training and monitoring, ICF/IID admissions, eligibility reviews, and other ...

New

Crawford and Company

Medical Case Manager

Las Vegas, NV · On-site

$52K - $96K/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 ...

State of Florida

MEDICAL CASE MANAGER - 67073539

Tampa, FL · Hybrid

$2K - $3K/wk

Primary duties include, but are not limited to, clinical oversight of medical case reviews, medication administration training and monitoring, ICF/IID admissions, eligibility reviews, and other ...

New

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Medical Case Reviewer information

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How much do medical case reviewer jobs pay per hour?

As of Jun 10, 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 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.

What are Medical Case Reviewers?

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, and why are they important?

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.
More about Medical Case Reviewer jobs
What cities are hiring for Medical Case Reviewer jobs? Cities with the most Medical Case Reviewer job openings:
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 June 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $58,003 per year, or $27.9 per hour.

Surgical Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours)

Broadway Ventures

Remote

Part-time

Posted 3 days ago

Job description

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation.
Are you a board-certified physician looking for a flexible, remote opportunity to apply your clinical expertise? We are seeking experienced physicians to conduct independent case reviews for the Department of Veterans Affairs (VA). This role involves evaluating medical cases to assess quality of care, adherence to standards, and opportunities for improvement.
This is an ideal opportunity for physicians seeking part-time, flexible work that complements their clinical practice.
Position Details:
  • Job Type: Part-time
  • Location: Fully remote (U.S. only)
  • Schedule: Flexible-complete cases at your convenience within 5 calendar days
  • Case Volume: Varies monthly-no fixed predictions by specialty or case type

Key Responsibilities:
  1. Medical Case Audits & Quality Reviews
  • Conduct objective medical case reviews using standardized assessment criteria
  • Evaluate the timeliness and appropriateness of care provided
  • Identify quality improvement opportunities
  1. Performance Improvement & Specialty Case Reviews
  • Review cases initiated for non-standardized performance improvement reasons
  • Assess medical decision-making and compliance with best practices
  1. Medical Advisory Opinions
  • Provide expert medical opinions
  • Analyze complex clinical scenarios from an impartial, evidence-based perspective

Qualifications & Requirements:
To be eligible for this role, you must meet the following criteria:
  • Active, unrestricted physician license in any U.S. state or territory
  • Board certification in a specialty recognized by the American Board of Medical Specialties
  • Minimum of 5 years of clinical experience in your specialty
  • Minimum of 2 years of recent clinical practice relevant to case reviews
  • Actively engaged in direct patient care (minimum 20 clinical hours per month)
  • Hospital privileges in your specialty
  • Fluent in English (strong reading and writing skills required)

Open Positions by Specialty:
  • Surgery Specialties Bariatric Surgery
  • Surgery Specialties Cardio-Thoracic Surgery
  • Surgery Specialties Colo-Rectal Surgery
  • Surgery Specialties Neurosurgery
  • Surgery Specialties Orthopedics-Spine
  • Surgery Specialties Thoracic Surgery

Why Join Us?
• Fully remote work-complete cases on your own schedule
• Flexible hours- ability to complete reviews within 5 days on your own time
• No court appearances-your reviews remain confidential
• Make a meaningful impact-help improve healthcare standards for veterans
How to Apply:
If you meet the qualifications and are interested in joining our team, apply today!
What to Expect Next:
After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.
Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.
Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).

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