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Medical Insurance Reviewer Jobs (NOW HIRING)

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Medical Insurance Verification Specialist

Dallas, TX

$16.75 - $20.75/hr

Medical Insurance Verification Specialist Location: Dallas - Hospital Additional Posting Details ... review * Request and secure referrals from Primary Care Physicians and Insurance companies

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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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How much do medical insurance reviewer jobs pay per hour?

As of Jul 22, 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.
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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 Collections Specialist

NuView Solutions LLC

Boca Raton, FL

$17.25 - $21.50/hr

Other

Medical, PTO

Re-posted 25 days ago

Job description

Description

 Location: On-Site Boca Raton, FL
We are seeking an experienced Medical Insurance Collections Specialist to join our healthcare team. The ideal candidate will have strong knowledge of medical billing and insurance collections. This role is responsible for resolving outstanding insurance claims, following up on unpaid balances, and ensuring timely reimbursement from insurance carriers.


Responsibilities

  • Follow up on unpaid or denied medical insurance claims 
  • Review and resolve claim rejections, denials, and underpayments 
  • Communicate with insurance companies regarding claim status and appeals 
  • Work aging reports and maintain collection goals 
  • Verify patient insurance eligibility and benefits 
  • Collaborate with billing, coding, and clinical staff to resolve account issues 
  • Maintain compliance with HIPAA and payer regulations 
  • Utilize telehealth billing knowledge to ensure proper claim submission and reimbursement 
  • Work within eClinicalWorks for account review, documentation, and claim management 

Requirements

Qualifications

  • Minimum 2 years of medical insurance collections experience 
  • Knowledge of CPT, ICD-10, and insurance guidelines 
  • Familiarity with Medicare, Medicaid, and commercial payers 
  • Strong attention to detail and problem-solving skills 
  • Excellent communication and organizational abilities 
  • Ability to work independently and meet productivity goals 

Benefits

  • Competitive salary 
  • Paid time off and holidays 
  • Health insurance benefits 
  • Supportive team environment 

To Apply:
Please submit your resume and a brief summary of your medical collections and telehealth experience.


Apply