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Medical Document Reviewer Jobs (NOW HIRING)

Unitedlex

Consultant - Document Review - Virtual

$70K - $90K/yr

The Consultant-Document Review is an operational role focused on designing and executing e ... In addition to our core benefits (medical, dental, and vision), we offer generous time off policies ...

PGBA, LLC

Reviewer I, Medical

Myrtle Beach, SC · On-site

Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Description Why should you join the BlueCross ...

Ourhrconnect

Reviewer I, Medical

Myrtle Beach, SC

Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Description Why should you join the BlueCross ...

Ourhrconnect

Reviewer I, Medical

Myrtle Beach, SC

Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Description Why should you join the BlueCross ...

ARC

HIM Document Capture Specialist (PRN)

Austin, TX · On-site

Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term ... For further information, please review the Know Your Rights notice from the Department of Labor.

Verve LLC

Medical Nurse Reviewer

Baltimore, MD · On-site

Review hospice claims, clinical documentation, and provider records to assess compliance with Medicare and Medicaid hospice regulations. * Conduct medical necessity reviews to determine ...

US Bank

Document Review Assoc 4-2

Jacksonville, FL · On-site

$20 - $26.39/hr

The Document Review Associate performs routine and/or repetitive clerical functions according to ... Our benefits include the following: * Healthcare (medical, dental, vision) * Basic term and ...

Hunterdon Health

Documentation Review Nurse

Flemington, NJ · On-site

$93K - $116K/yr

Documentation Review Nurse Position Summary The Documentation Review Nurse will apply expertise and ... Benefit offerings vary based on status and may include but not be limited to medical, dental ...

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Medical Document Reviewer information

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$11

$42

$100

How much do medical document reviewer jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for medical document 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 are the typical daily responsibilities of a Medical Document Reviewer?

As a Medical Document Reviewer, your typical day will involve carefully reviewing and validating medical records, charts, or insurance documents to ensure accuracy, completeness, and compliance with regulations. You may collaborate with healthcare providers or administrative teams to clarify ambiguous information or request missing data. Attention to detail is vital, as minor errors could affect billing, patient care, or legal compliance. This role often offers both independent and collaborative work, depending on the employer, and provides opportunities to develop expertise in regulatory and documentation standards.

What is a Medical Document Reviewer job?

A Medical Document Reviewer analyzes medical records, insurance claims, and other healthcare-related documents for accuracy, compliance, and completeness. They ensure that medical documentation aligns with regulatory standards and organizational policies. This role is common in insurance companies, law firms, and healthcare organizations, where accurate medical documentation is crucial for claims processing, legal cases, and patient care. Strong attention to detail, medical knowledge, and familiarity with industry regulations are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Medical Document Reviewer position, and why are they important?

To thrive as a Medical Document Reviewer, you need a solid understanding of medical terminology, healthcare documentation standards, and relevant regulatory guidelines, typically supported by a degree in health sciences, nursing, or a related field. Familiarity with electronic health record (EHR) systems, coding software, and compliance tools like HIPAA guidelines is essential. Strong attention to detail, analytical thinking, and effective written communication are crucial soft skills for success. These abilities ensure the accurate, compliant, and timely review of medical documents, directly impacting patient care and organizational integrity.

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Medical Document Reviewer jobs near you
Medical Reviewer

Medical Reviewer

Community Health Network of Connecticut, Inc.

Wallingford, CT • On-site

$174K - $249K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 8 days ago

Job description

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Medical Reviewer.

Primary Responsibilities:

  • Under the general direction of the Vice President of Clinical Affairs, performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP).
  • Participates and contributes actively in medical matters related to utilization management, case management, peer review, quality improvement and other processes requiring medical/clinical leadership and consultation.
  • Responds to inquiries from providers, internal stakeholders, and Department of Social Services as necessary.
  • Serves as a resource to CHNCT clinical staff.
  • Provides recommendations for improving care delivery and health outcomes for CMAP enrollees.
  • Participates in activities specific to contractual requirements such as Fair Hearings, etc.

Tasks Performed:

  • Appropriately documents case review findings, actions, and outcomes in keeping with established policies.
  • Collaborates with clinical staff to implement clinical and quality management programs and initiatives.
  • Interacts with providers and vendors regarding clinical care and services for CMAP enrollees.
  • Actively participates and contributes in medical review team meetings; participates in design and development of care programs and quality improvement initiatives as requested.

Essential Functions:

  • Engages in telephonic case review and discussion with providers.
  • Proactively shares resources, information and guidelines related to quality, cost-effective health care delivery.
  • Shares best practices with other Medical Reviewers, CHNCT clinical staff.
  • Applies performance data to guide interactions and inform discussions with stakeholders.
  • Maintains a high level of productivity; adheres to ASO contract standards regarding timeliness of reviews and appeals.
  • Consistently meets plan inter­rater reliability guidelines.
  • Required to attend Medical Reviewer Staff Meetings via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings.
  • Required to be available for all training/retraining sessions via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings. Note: training and retraining sessions may vary from year to year depending on assessment and need.
  • Required to attend all mandatory training provided by DSS.
  • Must comply with completing all company required trainings.

Desired Education: Medical School

Desired Degree: Medical Doctor or Doctor of Osteopathy

Desired Major: Primary care specialty

Desired Job Experience: Minimum 2 years as a Medical Reviewer or physician consultant in a managed care company preferred. Experience in Utilization Management, Case and Disease Management, preferably with Medicaid populations. Clinical experience in managing a range o1 pathologies and populations and up-to-date knowledge of evidence-based medical guidelines and accepted standards of care for managing the treatments, procedures, conditions, and diseases under review by CHNCT.

Other Qualifications: M.D. or D.O. current, non-restricted Connecticut license and Board certification. Flexible and able to adapt to altered work processes, technologies, and directives.

Certifications Required: Physician; Surgeon

CHNCT Offers Great Benefits:

  • Medical, dental and vision coverage options
  • Flexible spending and health savings accounts
  • Group term life insurance
  • A 401(k) plan with company-match and immediate vesting
  • Voluntary accidental injury coverage
  • Tuition reimbursement and continuing education opportunities
  • A generous paid-leave bank and company holidays
  • Wellness program

We are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment.

We are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.