ZipRecruiter

Log In

1

Medical Review Jobs (NOW HIRING)

Managed Medical Review Organization

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.

Lifehealth LLC

Medical Review RN

Washington, DC · On-site

$45/hr

Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location: Washington, DC Position Summary: LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review ...

Empower AI

Medical Reviewer III (Medicare/DRG)

Medical Review Specialist III (Medicare DRG) Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation.

Empower AI Inc.

As a casual Medical Review Specialist III (Medicare DRG) for Empower AI, Inc., you will perform Medicare comprehensive medical record and claims review to make payment determinations for Diagnosis ...

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

Perform automated and complex medical record and claim reviews to make coverage determinations based on applicable Medicare coverage policies and payment rules, coding guidelines, National and Local ...

KARNA LLC

Medical Claims Review Nurse

Atlanta, GA · On-site

This position for a medical claims review nurse on the World Trade Center (WTC) Health Program will have a direct impact on members of the program. The nurse will be responsible for reviewing claims ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

Perform automated and complex medical record and claim reviews to make coverage determinations based on applicable Medicare coverage policies and payment rules, coding guidelines, National and Local ...

Abbott

Medical Review Officer (MRO)

Kansas City, KS · On-site +1

Reviews and interprets drug test results, including determining legitimate medical explanations in accordance with federal regulations. * Ensures compliance with specimen collection procedures, chain ...

Empower AI Inc.

As a casual Medical Review Specialist III (Medical Reviewer III) you will primarily perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare PART A.

Empower AI Inc.

As a casual Medical Review Specialist III (Medical Reviewer III) you will primarily perform Medicare comprehensive medical record and claims review to make payment determinations for Medicare PART A.

next page

Showing results 1-20

People also search for

All JobsMedical Review Jobs

Medical Review information

See salary details

$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 Nurse - RN

Medical Review Nurse - RN

TDY Medical Staffing, Inc

Mechanicsburg, PA • On-site

Other

Posted 2 days ago

Job description

TDY Medical Staffing, Inc. is currently seeking Medical Review Nurses for a short term 1-2 month contract position located in Mechanicsburg, PA area. This is a Monday - Friday Day Shift position. Please do NOT apply if you are not willing to work forty hours per week. Once you apply, please check your email as we will communicate with you via this means.

Please read everything below before applying and only apply if you are fully qualified. Preference given to applicants with previous medical review experience.
MINIMUM REQUIREMENTS
  • Bachelor's Degree or equivalent work experience.
  • Active RN license
  • 1 Years Clinical Experience
  • Strong written and oral communication skills
  • Be able to research medical and health care delivery issues
  • Possess an aptitude for data analysis.
Must have computer experience. Please submit a resume with 3 professional references - please list your skills online in the area provided after you hit the APPLYbutton. If you do not submit a resume with professional references, you will not be considered for employment.
Start Date: ASAP
Assignment Duration: 1-2 months - potential for monthly extensions
Work Hours: 40 Hours/Week
Does not require travel.
Must be eligible to work in the United States.
Essential Duties & Responsibilities:
Performs medical review of pre and post payment claims.
Identifies providers needing education and individually educates providers who are subject to medical review processes.
Identifies problem providers through data analysis and by monitoring provider reasons for denial through claim review logs, develops and implements corrective action plans designed to ensure the resolution of issues related to coding, documentation and medical necessity/coverage.
  • Make medical review claims adjudication decisions.
  • Review provider practices and identify issues of concern, overpayment and need for corrective action.
  • Develop recommendations for further corrective action based on medical review findings.
  • Implement corrective action related to medical review activities.
  • Performs other duties as the supervisor may, from time to time, deem necessary.

PREFERRED Knowledge, Skill, Education/Training and Experience Requirement.:
Computerized Patient Records System
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
TDY Medical Staffing, Inc. is an Equal Opportunity Employer and takes pride in maintaining a diverse environment. All qualified applicants will receive consideration for employment without regard to their race, color, religion, gender, gender identity, national origin, age, sexual orientation, marital or protected veteran status, disability, or any other legally protected status. If you'd like more information about your EEO rights as an applicant under the law, please click here.
Once you hit the "Apply Now" button, you will be directed to enter into your information into our website general application - There will be several questions asked to ensure our Affirmative Action/EEOC compliance. Your participation is voluntary and will have no impact on the interview process.
TDY is a federal contractor and as such is required to provide self-identification questions regarding race/gender/disability/veteran status to all qualified applicants. We offer all applicants the VOLUNTARY opportunity to respond to the questions.
You are under no obligation to respond to the questions and not answering the questions will have no impact on the application process or hiring decisions. Your responses are not seen by the hiring authority and have zero impact on our decision making process. Submitting this general application is not an offer of employment and does not a guarantee that the application process will proceed.

Apply