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Medical Insurance Reviewer Jobs (NOW HIRING)

Barry G Willens MD PA

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Medical Insurance Specialist

New Caney, TX · On-site

$17.36 - $20.68/hr

Review patient demographics and insurance information for accuracy * Document verification ... Previous medical insurance verification and referral experience required * Knowledge of commercial ...

Unison Health

Fair Hearing - Medical Insurance

Toledo, OH · On-site

$29.25 - $38.75/hr

Medical with federal minimum deductibles * Dental and Vision coverage * Retirement planning and ... Ensure Notices of Action are issued and reviewed for compliance, including required timelines ...

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Medical Insurance Reviewer information

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$11

$42

$100

How much do medical insurance reviewer jobs pay per hour?

As of Jun 30, 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 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?

A medical reviewer needs strong knowledge of medical terminology, healthcare regulations, and insurance policies. Critical thinking, attention to detail, and good communication skills are essential for evaluating claims accurately. Familiarity with electronic health records (EHR) systems and relevant certifications, such as a nursing license or medical degree, can also be important.

How to become a medical claims examiner?

To become a medical claims examiner, typically one needs a high school diploma or equivalent, with many employers preferring postsecondary education or certification in health insurance or medical billing. Relevant skills include attention to detail, knowledge of insurance policies, and familiarity with medical coding systems like ICD or CPT. Gaining experience through entry-level claims processing roles can also be beneficial.

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.

What is an insurance reviewer?

A medical insurance reviewer evaluates insurance claims and medical documentation to determine coverage eligibility and payment amounts. They analyze medical records, verify policy details, and ensure compliance with insurance policies, often using specialized software and requiring knowledge of healthcare regulations.

How do you 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 insurance. Additional certifications like a medical license and knowledge of medical coding or insurance policies can be beneficial. Strong analytical skills and attention to detail are essential for reviewing medical records and determining coverage eligibility.
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 June 2026, with employment types broken down into 80% Full Time, and 20% Part Time. Highlights an 70% In-person, and 30% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

Medical Insurance Specialist

Barry G Willens MD PA

New Caney, TX • On-site

$17.36 - $20.68/hr

Other

Medical, PTO

Posted 4 days ago

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Job description

The New Caney Clinic is seeking a depending and detail-oriented Insurance Verification Specialist to join our growing family practice team.

Responsibilities:

  • Verify patient insurance benefits and eligibility
  • Obtain prior authorizations and referrals through insurance portal
  • Communicate with insurance companies regarding coverage and benefits
  • Communicate specific CPT code to the insurance companies via verbal not portals-
  • Review patient demographics and insurance information for accuracy
  • Document verification information accurately in patient records
  • work closely with providers, billing staff, and front office personal, filing
  • EMR experience

Qualifications:

  • Previous medical insurance verification and referral experience required
  • Knowledge of commercial, Medicare, Medicaid, and Managed care plans
  • Familiarity with prior authorizations and referral
  • Excellent communication and customer service abilities
  • Ability to multitask in a busy medical office

What we Offer:

  • Full-time position
  • Competitive pay based on experience
  • Paid holidays
  • Insurance benefits available
  • Supportive team environment
  • Opportunity for a three-day weekend schedule after training.

If you are motivated, dependable, and enjoy helping patients navigate the insurance process, we would love to hear from you.

Apply today and join our team at The New Caney Clinic!

Please submit your resume and include "Insurance Specialist" in the Subject Line.

Company Description

English/Spanish-Bilingual trained candidates are valued but experience is most important.
The business is a thriving company that has been in busy for 35plus years with a great work ethic
We understand that life gets messy and we work with our employee's to stay family focused.
Hiring right away- My employee is retiring after 20+ years of employment.