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$11

$42

$100

How much do medical insurance reviewer jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for medical insurance 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 the easiest healthcare job that pays well?

A Medical Insurance Reviewer is a healthcare role that typically requires attention to detail and knowledge of insurance policies. It often offers a good salary with minimal physical demands and can sometimes be performed remotely, making it accessible for many job seekers. Certification in insurance or healthcare administration can enhance job prospects and earning potential.

What are some common challenges faced by Medical Insurance Reviewers when handling claim approvals?

Medical Insurance Reviewers often encounter challenges such as interpreting complex medical documentation, staying updated with evolving insurance policies, and ensuring compliance with regulatory requirements. Balancing the need for thorough analysis with the pressure of meeting turnaround times can also be demanding. Effective communication with healthcare providers and policyholders is key to resolving discrepancies and ensuring claims are processed accurately and efficiently.

What are the key skills and qualifications needed to thrive as a Medical Insurance Reviewer, and why are they important?

To thrive as a Medical Insurance Reviewer, you need a solid understanding of medical terminology, claims processing, and healthcare regulations, often supported by experience in healthcare administration or a related certification. Familiarity with claims management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for accurately evaluating claims and collaborating with healthcare providers. These skills ensure accurate claim assessments, compliance with regulations, and efficient processing, which are critical for minimizing errors and supporting the financial health of both insurers and patients.

What skills do you need to be a medical reviewer?

Medical insurance reviewers need strong knowledge of medical terminology, healthcare regulations, and insurance policies. They should have excellent attention to detail, analytical skills, and the ability to interpret medical records and documentation. Familiarity with electronic health record systems and relevant certifications, such as Certified Professional Coder (CPC), can also be beneficial.

What do medical reviewers do?

Medical reviewers evaluate insurance claims and medical documentation to determine the appropriateness and coverage of medical services. They analyze patient records, ensure compliance with policies, and may use medical coding and clinical guidelines to make informed decisions. Strong knowledge of medical terminology and insurance policies is essential for this role.

How to become a medical reviewer?

To become a medical reviewer, candidates typically need a medical degree such as an MD or DO, along with experience in healthcare or medical coding. Certification in medical coding or billing, like CPC or CCS, can enhance prospects, and strong analytical skills are essential for reviewing medical records and claims efficiently.

What does a Medical Insurance Reviewer do?

A Medical Insurance Reviewer is responsible for evaluating medical claims submitted by healthcare providers to ensure they meet policy guidelines and are medically necessary. They review patient records, treatment plans, and insurance policies to determine coverage eligibility and approve or deny claims accordingly. Their work helps prevent fraudulent or incorrect payments and supports both insurance companies and insured individuals in navigating the claims process.
More about Medical Insurance Reviewer jobs
What cities are hiring for Medical Insurance Reviewer jobs? Cities with the most Medical Insurance Reviewer job openings:
What states have the most Medical Insurance Reviewer jobs? States with the most job openings for Medical Insurance Reviewer jobs include:
What job categories do people searching Medical Insurance Reviewer jobs look for? The top searched job categories for Medical Insurance Reviewer jobs are:
Medical Insurance Reviewer jobs near you
Infographic showing various Medical Insurance Reviewer job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 70% Full Time, 23% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

Medical Insurance Biller

Integrated Autism Centers

Warren, MI • On-site

$23 - $26/hr

Full-time

Posted 6 days ago

Job description

Medical Biller & Authorizations Representative — Integrated Autism Centers

About Us: Integrated Autism Centers provides high-quality autism diagnostic and therapy services (ABA, speech, and occupational therapy) to children and families across Metro Detroit. We're looking for a sharp, dependable Medical Biller to own our revenue cycle from authorization to payment.
The Role: This is a high-trust, full-time position for someone who knows their way around insurance billing and takes pride in clean claims and a healthy A/R. You'll be the point person for our billing operations — submitting claims, chasing denials, tracking authorizations, and making sure every service we deliver gets paid. The ideal candidate is detail-obsessed, persistent with payers, and comfortable owning the full billing cycle with minimal hand-holding.
Key Responsibilities:
  • Claims Submission: Prepare and submit clean claims for ABA, speech, and OT services to commercial payers and Medicaid; verify CPT codes, modifiers, units, and documentation before submission.
  • Denials & Appeals: Work denials and rejections promptly; prepare appeals and resubmissions, communicate with payers, and resolve issues to keep revenue flowing.
  • Insurance Authorizations: Submit, track, and follow up on authorizations and reauthorizations; monitor expiration dates and unit utilization to keep services uninterrupted.
  • Payment Posting & Reconciliation: Post ERAs/EOBs, reconcile payments against expected reimbursement, and flag underpayments or contract discrepancies.
  • A/R Management: Monitor aging reports, follow up on outstanding claims, and keep days-in-A/R low; provide regular reporting to leadership on collections and claim status.
  • Eligibility & Benefits Verification: Verify patient coverage and benefits at intake and re-verify as needed; communicate patient responsibility clearly to families.
  • Payer Documentation Requests: Gather and submit clinical documentation in response to payer records requests and pre-payment reviews, working with clinical staff to meet deadlines.

What We're Looking For:
  • 1+ years of medical billing experience; ABA, behavioral health, or pediatric therapy billing strongly preferred.
  • Working knowledge of CPT/ICD-10 coding, modifiers, and payer-specific billing rules; familiarity with BCBSM, Blue Care Network, HAP, UHC/Optum, Priority Health, and Michigan Medicaid is a strong plus.
  • Experience with practice management/EMR systems and clearinghouses (CentralReach experience a plus).
  • Strong follow-through and persistence — comfortable getting payers on the phone and staying on a claim until it's resolved.
  • Excellent attention to detail and organizational skills; able to manage multiple payers, deadlines, and priorities at once.
  • Clear written and verbal communication with families, staff, and insurance companies.
  • Discretion and reliability when handling PHI and confidential financial information; understanding of HIPAA requirements.