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Medical Review Jobs (NOW HIRING)

Saratoga Ascend

Medical Review Manager

Catonsville, MD · On-site

Medical Review Manager Saratoga Medical has an immediate opening for a Medical Review Manager for a program supporting the Centers for Medicare and Medicaid Services (CMS) in Catonsville, MD. The ...

i3logix

Medical Review Specialist

Denver, CO · On-site

$21/hr

Medical Review Specialist (MRS) About i3screen: i3screen is a privately held subsidiary of i3logix, a provider of enterprise document management solutions, scheduling solutions, and custom software.

HireRight

Senior Medical Review Officer

Atlanta, GA · On-site

Overview The Senior Medical Review Officer (MRO) serves as the organization's senior medical authority for drug testing and occupational health review, ensuring all medical determinations are ...

MedWatch, LLC

Medical Review Specialist/RN

$64K - $68K/yr

The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and confirming the medical necessity of hospital admissions and/or ...

Prime Healthcare

Medical Review Coordinator I

Elgin, IL · On-site

$32 - $46.35/hr

Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. Serves as on-going educator to all departments. Responsible ...

Empower AI Inc.

Medical Review Specialist V

Review medical documentation for medical necessity utilizing clinical knowledge and Center for Medicare Services (CMS) policies and guidelines, as well as other state and board regulations.

Novacore

Medical Review Nurse

Conshohocken, PA · Remote

Medical Review Nurse Carbon Stop Loss Solutions is a leading managing general underwriter (MGU) in the field of employer stop loss and managed care insurance. Carbon's team of experts are known as ...

AstraZeneca

Senior Manager, US Medical Review

Boston, MA · On-site

$116K - $175K/yr

The Senior Manager, US Medical Review will sustain and promote Alexion's professional standing and integrity amongst patients, health care professionals and the pharmaceutical / biotech industry by ...

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Medical Review information

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$36.5K

$164.7K

$337K

How much do medical review jobs pay per year?

As of Jul 8, 2026, the average yearly pay for medical review in the United States is $164,731.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,000.00 and $268,500.00 per year, depending on experience, location, and employer.

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

To thrive as a Medical Reviewer, you need a strong understanding of clinical medicine, scientific research, and regulatory guidelines, often supported by a medical degree or advanced healthcare qualification. Familiarity with medical databases, regulatory submission systems, and tools like MedDRA coding or CTD formatting is typically required. Attention to detail, analytical thinking, and effective written communication are essential soft skills for reviewing complex documents and collaborating with multidisciplinary teams. These skills ensure accurate, compliant, and high-quality medical evaluations that support regulatory approvals and patient safety.

What is medical review?

Medical review refers to the process of evaluating medical information, records, or claims to ensure accuracy, compliance, and appropriateness based on clinical guidelines and policies. Professionals in medical review often assess documentation for insurance claims, pre-authorization requests, or clinical trials. Their work helps ensure that patients receive appropriate care and that healthcare providers follow industry standards.

How does a Medical Review professional typically collaborate with other departments within a healthcare or insurance organization?

Medical Review professionals frequently work closely with clinical staff, claims adjusters, and compliance teams to ensure that medical records and claims are accurately assessed and meet regulatory standards. Collaboration often involves discussing complex cases, clarifying clinical documentation, and providing guidance on policy interpretation. Effective communication and teamwork are essential, as Medical Review staff often act as a bridge between medical and administrative teams to support fair and thorough claims processing.

How to become a medical reviewer?

To become a medical reviewer, typically a healthcare professional such as a physician, nurse, or pharmacist with relevant clinical experience is required. Candidates often need a medical license, strong knowledge of medical guidelines, and familiarity with medical documentation and review processes. Additional certifications or training in medical coding, compliance, or insurance review can enhance qualifications.

What is the role of a medical reviewer?

A medical reviewer evaluates medical records, claims, and documentation to ensure accuracy, compliance, and appropriate treatment. They often work in insurance, healthcare, or regulatory settings, requiring clinical knowledge and attention to detail to make informed decisions about patient care or claims processing.

What jobs make $3,000 a month without a degree?

Medical review roles, such as medical coders or billers, can pay around $3,000 monthly without requiring a degree, often needing certification and familiarity with healthcare software. Other non-degree jobs that may reach this income level include sales representatives, certain skilled trades, or administrative roles with experience, but these typically require specific skills or certifications. Income varies based on location, experience, and industry demand.

What is the difference between Medical Review vs Medical Coding Specialist?

AspectMedical ReviewMedical Coding Specialist
Required CredentialsMedical degree or clinical background, certifications like CCM or CRCCertification in coding (CPC, CCS), knowledge of coding systems
Work EnvironmentHealthcare facilities, insurance companies, telehealthHospitals, clinics, insurance companies, remote coding
Employer & Industry UsageUsed to assess medical necessity, compliance, and documentationUsed to assign billing codes based on medical records

Medical Review involves evaluating medical records for accuracy, compliance, and appropriateness, often requiring clinical expertise. Medical Coding Specialists focus on translating medical documentation into standardized codes for billing and insurance purposes. While both roles require healthcare knowledge, Medical Review emphasizes clinical assessment, whereas Medical Coding centers on coding accuracy for reimbursement.

What is the 3 month rule for jobs?

In the context of medical review jobs, the 3 month rule often refers to a probationary period during which an employee's performance is closely monitored before full employment benefits or permanent status are granted. This period allows employers to assess the employee's skills, reliability, and fit for the role, which may include tasks like reviewing medical records or ensuring compliance with healthcare regulations.
More about Medical Review jobs
What cities are hiring for Medical Review jobs? Cities with the most Medical Review job openings:
What are the most commonly searched types of Medical Review jobs? The most popular types of Medical Review jobs are:
What states have the most Medical Review jobs? States with the most job openings for Medical Review jobs include:
Medical Review jobs near you

Medical Review Manager

Saratoga Ascend

Catonsville, MD • On-site

Other

Posted 19 days ago

Job description

Medical Review Manager

Saratoga Medical has an immediate opening for a Medical Review Manager for a program supporting the Centers for Medicare and Medicaid Services (CMS) in Catonsville, MD. The work hours are Monday to Friday from 8:30 am to 5:00 pm.

Qualifications:

  • Board certified in nursing and licensed to practice nursing in the U.S. and a currently licensed RN
  • Minimum of five years of experience practicing as an RN in either an acute hospital, skilled nursing facility, or an office/clinic-based medical practice
  • Minimum of two years of experience of supervisory experience with Medicare's program coverage and payment rules
  • Experience in MR processes of Medicare Administrative Contractors (MACs), CERT, Supplemental Medical Review Contractor (SMRC), or Railroad Retirement Board (RRB) MAC is preferred

Responsibilities:

  • Supervise the Nurse Review staff
  • Development, oversight, and implementation of the CERT accuracy medical review processes while supervising the medical review nurses
  • Collaborate with the Program Manager, CMD, and other contract staff

Saratoga Medical Center, Inc. is an equal opportunity employer and will not discriminate in recruiting, hiring, training, promotion, transfer, discharge, compensation or any other term or condition of employment on the basis of race, religion, color, age (over age 39), sex, national origin, or on the basis of disability if the employee can perform the essential functions of the job, with a reasonable accommodation if necessary.

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