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Medical Review Physician Jobs (NOW HIRING)

Solomon Page

Medical Case Review Physician

Warren, NJ · On-site

$140 - $150/hr

Our client is looking to fill the role of Medical Case Review Physician. * Pay Range - $140/hr-$150/hr * Remote Opportunity * 4-6+ month contract Responsibilities: * Perform medical review and ...

Capitol Bridge, LLC.

$250/wk

DERMATOLOGY GASTROENTEROLOGY IMMUNOLOGY INTERNAL MEDICINE MEDICAL ONCOLOGY OBSTETRICS ORTHOPEDICS ... We are looking to build our panel of Claims Review Physicians. This is a flexible, fully remote ...

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Medical Review Physician information

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$97.5K

$217.4K

$350K

How much do medical review physician jobs pay per year?

As of Sep 7, 2026, the average yearly pay for medical review physician in the United States is $217,445.00, according to ZipRecruiter salary data. Most workers in this role earn between $190,000.00 and $244,500.00 per year, depending on experience, location, and employer.

What is a medical review physician?

Medical Review Physicians are licensed doctors who evaluate medical information to ensure accuracy, compliance, and quality in healthcare processes. They often review patient records, insurance claims, and clinical trial data to determine the appropriateness of medical treatments and services. Their role is crucial in healthcare organizations, insurance companies, and regulatory bodies, as they help maintain standards and prevent errors or fraud. Medical Review Physicians use their clinical expertise to interpret complex medical data and make informed decisions that impact patient care and organizational policies.

What skills and qualifications are needed to thrive as a medical review physician?

To thrive as a Medical Review Physician, you need a medical degree (MD or DO), an active medical license, and a strong background in clinical practice and medical guidelines. Familiarity with electronic medical records (EMR) systems, utilization management software, and board certification in a specialty are commonly required. Critical thinking, attention to detail, and effective written and verbal communication skills help you interpret clinical documentation and explain decisions clearly. These skills ensure accurate, ethical, and timely medical reviews that support patient care quality and regulatory compliance.

What are common challenges medical review physicians face when evaluating complex cases?

Medical Review Physicians often encounter challenges when reviewing cases that involve incomplete medical records, ambiguous clinical information, or conflicting opinions from different healthcare providers. Navigating these scenarios requires careful analysis, effective communication with healthcare professionals, and a strong understanding of current clinical guidelines. Additionally, balancing the need for thoroughness with the demands of timely decision-making can be a significant aspect of the role. Collaboration with multidisciplinary teams and ongoing education can help address these challenges.

What is the difference between Medical Review Physician vs Medical Director?

AspectMedical Review PhysicianMedical Director
CredentialsMedical degree, medical license, often board-certified in a specialtyMedical degree, medical license, board certification, leadership experience
Work EnvironmentHealthcare facilities, insurance companies, review organizationsHealthcare organizations, hospitals, insurance companies, overseeing clinical operations
Employer & Industry UsageUsed primarily for reviewing medical records, claims, or complianceUsed for managing clinical teams, policy development, and strategic planning

The Medical Review Physician focuses on evaluating medical records and claims for accuracy and compliance, often working in review organizations or insurance companies. In contrast, the Medical Director oversees clinical operations, manages medical staff, and develops policies within healthcare organizations. Both roles require medical credentials, but their responsibilities and work environments differ significantly.

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What states have the most Medical Review Physician jobs?

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Medical Review Physician jobs near you
Infographic showing various Medical Review Physician job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $217,445 per year, or $104.5 per hour.

Hospice Physician Audit Reviewer (Remote)

VITAS Healthcare

Miramar, FL • On-site

Full-time

Posted 17 days ago

VITAS Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 115 frontline employees who took The Breakroom Quiz

34th of 247 rated social care providers

Job description

Hospice Physician Audit Reviewer will have experience supporting external government record requests by preparing chart summaries and expert testimony at administrative hearings as needed. In addition, although this position's responsibilities will usually be conducted from their home office, this role is also involved in travel to provider locations to provide in-person trainings and partner with program support initiatives as needed. Work remote.  
Experience:

  • The medical review physician should review the documentation submitted and identify the following content that support's the patient's appropriateness, including any higher level of care billed, if applicable: clinical history and physical findings, documentation of functional status and symptoms, and pertinent changes in plans of care.
  • The medical review physician should review certification / recertification worksheets and narratives, plans of care review, and interdisciplinary team notes to ensure that they collectively reflect and support the patient's hospice benefit appropriateness. Where there are inconsistencies or omissions, the physician should provide explanation or suggest correction.  
  • The medical review physician should prepare a summary (demographics, time of admission, course of care under review, disposition, statement of eligibility) outlining the patient's hospice benefit appropriateness and focus on bringing the claim reviewer's attention to the specific documentation that supports the patient's hospice eligibility, as well as any additional supportive documentation that may be added at the time of the appeal. Where appropriate, the medical review physician should reference evidence based guidelines or journal articles. 
  • If a detailed claim denial explanation was provided in the claim review summary, the medical review physician should: 1. Verify whether the claim denial code is legitimate for the level of care on date(s) in contention, 2. Identify if there are discrepancies between the claim review explanation and supporting documentation, 3. Address each claim denial reason with the necessary explanation and supportive documentation, 4. Identify whether there are additional chart documents not included in the first submission that establish hospice appropriateness. 
  • The chart review note submitted by medical review physician in preparation for submission of appeal, should summarize findings recorded elsewhere in the record and not conflict with daily progress notes. New information should be supported by additional documentation that has been accessed from the chart. 
  • Performs related duties as required. This position description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Education: 

  • Board eligible / certified in Hospice and Palliative Medicine, Family Medicine, Internal Medicine, or other related specialty with a working knowledge of the principles of palliative medicine and symptom management.
  • Completion of designated application and verification of credentials and qualifications.

Certification & Licensure:

  • Licensed to practice medicine or osteopathy in the state in which the program is operating.

Physical Requirements:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

SPECIAL INSTRUCTIONS TO CANDIDATES

  • EOE/AA M/F/D/V

What VITAS Healthcare employees say

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Hours and flexibility

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About VITAS Healthcare

Sourced by ZipRecruiter

VITAS Healthcare, located in Miami, FL, US, is a pioneer in the American healthcare industry, specifically within the realm of hospice care and palliative services. The company began its operations in 1978 under the visionaries Hugh Westbrook and Esther Colliflower,both social workers, who identified the need for compassionate end-of-life care. Recognizing the dire need to fill the void in hospice care, they established VITAS Healthcare with the mission to provide patients experiencing end-of-life stages with high-quality care, demonstrating respect for every individual's decisions and maintaining a supportive environment for both the patients and their loved ones. A noteworthy achievement of VITAS is that it was the first organization to have its hospice program licensed in Florida prompting a nationwide shift in the way end-of-life care services were handled.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US

Year founded

1978

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