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Medical Review Analyst Jobs (NOW HIRING)

EmblemHealth

Claims Review Analyst

New York, NY · On-site

$48K - $83K/yr

Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider ... Knowledge of medical terminology, ICD/CPT coding, per diem and DRG reimbursement and EDP testing ...

EmblemHealth

Claims Review Analyst

New York, NY · On-site

Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider ... Knowledge of medical terminology, ICD/CPT coding, per diem and DRG reimbursement and EDP testing ...

CoventBridge Integrity

$78 - $85/hr

Overview Medicaid Medical Review RN (Medical Reviewer III) - REMOTE The Medicaid Medical Review RN ... Advance knowledge of medical terminology and experience in the analysis and processing of Medicare ...

New

Lincare

Contract Review Analyst

Largo, FL · On-site

$62K - $75K/yr

This employee reviews payor contracts and information associated to contractual obligations ... Pursues, maintains, and communicates medical guideline changes * Helps facilitate interoffice ...

Lincare Holdings, Inc.

Contract Review Analyst

Largo, FL · On-site

$62K - $75K/yr

This employee reviews payor contracts and information associated to contractual obligations ... Pursues, maintains, and communicates medical guideline changes * Helps facilitate interoffice ...

Pae

Jr. Declassification Review Analyst

Springfield, VA · On-site

$60K - $66K/yr

The Junior Declassification Review Analyst will work at a client site in Springfield, VA to provide ... medical conditions related to pregnancy, childbirth, or breastfeeding), age, ancestry, United ...

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How much do medical review analyst jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for medical review analyst in the United States is $30.38, according to ZipRecruiter salary data. Most workers in this role earn between $20.43 and $36.06 per hour, depending on experience, location, and employer.

What is a medical review analyst?

Medical Review Analysts are professionals who evaluate medical records, insurance claims, or healthcare data to ensure accuracy, compliance, and adherence to regulations and policies. They often work for insurance companies, healthcare providers, or government agencies, reviewing documents to determine if medical services are justified and properly documented. Their role is crucial in preventing fraud, ensuring proper billing, and supporting quality healthcare delivery. Medical Review Analysts must have a strong understanding of medical terminology, coding, and healthcare regulations.

What are the key skills and qualifications needed to thrive as a medical review analyst?

To thrive as a Medical Review Analyst, you need a solid understanding of medical terminology, healthcare regulations, and clinical documentation, usually supported by a degree in a health-related field or nursing. Familiarity with medical coding systems (such as ICD-10 and CPT), claims management software, and regulatory compliance tools is essential. Attention to detail, analytical thinking, and strong written communication skills distinguish top performers in this role. These skills ensure accurate evaluation of medical claims, compliance with industry standards, and effective communication with healthcare providers.

What are some common challenges medical review analysts face when evaluating complex medical claims?

Medical Review Analysts often encounter challenges such as interpreting incomplete documentation, staying updated with evolving healthcare regulations, and ensuring compliance with payer guidelines. Analyzing complex or ambiguous medical records requires strong attention to detail and critical thinking skills. Collaboration with healthcare providers and other internal teams is frequently necessary to clarify information and support accurate decision-making. Successfully managing these challenges is crucial for maintaining the integrity of the claims review process and ensuring fair outcomes.

What is the difference between Medical Review Analyst vs Medical Claims Processor?

AspectMedical Review AnalystMedical Claims Processor
Required CredentialsTypically requires a healthcare-related certification or background, such as a nursing license or medical coding certificationUsually requires basic high school diploma or equivalent; some roles prefer medical billing or coding certification
Work EnvironmentOffice setting, reviewing medical records and claims, often involving detailed analysisOffice setting, processing and entering claims data, handling administrative tasks
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare providersHealth insurance companies, healthcare providers, billing companies

The Medical Review Analyst focuses on evaluating medical records and claims for accuracy and compliance, often requiring healthcare credentials. In contrast, Medical Claims Processors primarily handle the administrative processing of claims, with less emphasis on clinical knowledge. Both roles are essential in the healthcare insurance industry but differ in responsibilities and required qualifications.

How much do medical review analysts make in the US?

Medical review analysts in the US typically earn an average salary ranging from $45,000 to $70,000 per year, depending on experience, location, and employer. Entry-level positions may start lower, while experienced analysts with certifications can earn higher salaries, often with opportunities for overtime and bonuses.

How to become a medical review analyst?

To become a medical review analyst, candidates typically need a bachelor's degree in healthcare, nursing, or a related field, along with experience in medical coding, billing, or clinical review. Strong analytical skills, attention to detail, and familiarity with medical records and insurance policies are essential; certifications such as Certified Professional Coder (CPC) or Certified Medical Review Officer (CMRO) can enhance job prospects.
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Medical Review Analyst jobs near you
Infographic showing various Medical Review Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $63,187 per year, or $30.4 per hour.

Medical Review Specialist

Pensacola, FL • On-site

Consumer Attorney Records Services
See more jobs at Consumer Attorney Records Servicesexternal

Full-time

Posted 16 days ago

Job description


Medical Record Review Specialist
 
Job Title: Review Specialist I
 Department: Review
 FLSA Status: Non-Exempt
 Schedule: Monday-Friday,8:00am-5:00pm
 Location: On-SiteESSENTIAL FUNCTIONS
Medical Record Review and Information Processing

 

  • Review, analyze, and summarize medical records of varying length, complexity, and medical specialty.
  • Extract, organize, and document factual medical information in accordance with client-specific instructions, company procedures, and quality standards.
  • Complete work using company-approved electronic platforms.
  • Identify relevant information, omissions, inconsistencies, and documentation requirements.
  • Apply learned procedures, project requirements, feedback, and process updates consistently across assignments.


Independent Work Performance

 

  • Perform assigned duties with minimal supervision.
  • Organize, prioritize, and manage multiple assignments while meeting productivity, quality, and deadline requirements.
  • Exercise judgment and critical thinking within established guidelines and review parameters.
  • Adapt to changing priorities, client requirements, and business needs.


Confidentiality and Compliance

 

  • Maintain strict confidentiality of Protected Health Information (PHI) and other confidential information.
  • Comply with HIPAA requirements, company policies, confidentiality agreements, client requirements, and applicable security procedures.
  • Exercise discretion when accessing, reviewing, storing, and transmitting confidential information.


Administrative and Team Responsibilities

 

  • Accurately record work time using designated company systems.
  • Submit required reports and documentation within established deadlines.
  • Follow departmental procedures and quality standards.
  • Demonstrate professionalism, cooperation, flexibility, and responsiveness to coaching and feedback.
  • Support departmental and organizational objectives.


The employee must be able to:


  • Read, comprehend, analyze, and process complex medical documentation.
  • Extract and organize factual information accurately and objectively.
  • Apply written policies, procedures, and project-specific instructions consistently.
  • Exercise critical thinking and sound judgment within established guidelines.
  • Retain and recall detailed procedural and project-specific information.
  • Maintain exceptional attention to detail while performing repetitive computer-based tasks.
  • Prioritize and manage multiple assignments in a deadline-driven environment.
  • Work independently with minimal supervision.
  • Adapt to changing priorities and procedural updates.
  • Communicate professionally and maintain strict confidentiality


 PHYSICAL REQUIREMENTS

This position is primarily sedentary and requires prolonged sitting, keyboarding, mouse use, reading electronic medical records, viewing computer monitors, and performing repetitive hand and finger movements. Occasional standing, walking, reaching, and movement within the office may be required. Employees must be able to perform these essential functions with or without reasonable accommodation.

 WORK ENVIRONMENT

Work is performed primarily in a professional office setting and involves prolonged computer-based work. Employees regularly use dual monitors, keyboard, mouse, headphones, camera, and electronic record systems while working in a quiet environment that supports concentration, productivity, and confidentiality. Management-approved ergonomic accessories may be used provided they do not interfere with business operations, security requirements, or system functionality. 



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