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Medical Reviewer Jobs (NOW HIRING)

Community Health Network

Medical Reviewer

Medical Reviewer Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Medical Reviewer. Primary Responsibilities: * Under the general direction of the Vice President of ...

Healthfirst

Medical Peer Reviewer

Manhattan, NY · On-site

$122K - $187K/yr

The Medical Peer Reviewer will assess/review requests for authorization, and claims payment, based on medical records and internal Healthfirst information and make informed clinical judgments and ...

Ourhrconnect

Medical Reviewer II

Carolina, RI · On-site +1

Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated ...

Ourhrconnect

Medical Reviewer II

Carolina, RI · On-site +1

Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated ...

Ourhrconnect

Medical Reviewer II

Alabama, NY · On-site +1

Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated ...

Empower AI

Medical Reviewer III (Medicare/DME)

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

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.

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 ...

Swoop

Freelance Medical Reviewer, MyHealthTeam

$20 - $75/hr

Our medical reviewers ensure the accuracy of information like symptoms and treatments of a condition, medical terms, and statements about medical studies. Reviewers who are people of color or people ...

Empower AI Inc.

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

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.

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Medical Reviewer information

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$11

$42

$100

How much do medical reviewer jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for medical 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.

How does a Medical Reviewer typically collaborate with other departments during the drug approval process?

Medical Reviewers work closely with cross-functional teams, including clinical research, regulatory affairs, pharmacovigilance, and biostatistics. They review clinical trial data, ensure documentation complies with regulatory standards, and provide medical expertise during regulatory submissions. Effective communication is essential, as Medical Reviewers often participate in multidisciplinary meetings to address queries and ensure consistency in data interpretation throughout the approval process.

What Does a Medical Reviewer Do?

As a medical reviewer, your primary responsibilities are to review medical records to ensure accuracy. You address any issues or errors that you find with your supervisor’s assistance and contact medical providers to update information about patients. You may also audit medical files to determine whether the medical provider’s documentation complies with all federal and state regulations that affect accreditation, or if the facility qualifies for specific federal funding or participation in programs like Medicare. Medical reviewers most commonly work for an internal department at a hospital, medical care facility, or an outside organization, such as an insurance company or government agency.

What jobs pay $2000 a day?

Medical reviewers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or high-paying freelance positions. Some medical professionals, like top-tier consultants or specialists with extensive experience, may command high daily fees, especially when working independently or on contract basis. These roles often require advanced certifications, significant expertise, and a flexible schedule.

What is a medical reviewer?

A medical reviewer is a healthcare professional, often a licensed physician or nurse, responsible for evaluating medical records, claims, or documentation to ensure accuracy, compliance, and appropriate treatment. They typically review cases in insurance, healthcare, or pharmaceutical settings and may require knowledge of medical coding, regulations, and clinical guidelines.

What job makes $10,000 a month without a degree?

A medical reviewer can earn around $10,000 per month, especially with experience and specialization, often working remotely for healthcare companies or insurance firms. These roles typically require strong knowledge of medical terminology, attention to detail, and sometimes certification, but they do not always require a formal degree.

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 thorough understanding of medical terminology, clinical research, and regulatory guidelines, usually backed by a medical or pharmacy degree. Familiarity with tools like MedDRA, safety databases, and document management systems, as well as certifications in pharmacovigilance, are commonly required. Strong analytical skills, attention to detail, and effective written communication set standout professionals apart in this role. These skills ensure accurate evaluation of medical documents, regulatory compliance, and the safety of patients participating in clinical trials.

What is the difference between Medical Reviewer vs Medical Writer?

AspectMedical ReviewerMedical Writer
Required CredentialsMedical degree (MD, DO, PharmD), licensure often preferredBackground in life sciences, writing skills, often with a degree in related fields
Work EnvironmentPharmaceutical companies, CROs, regulatory agencies, hospitalsPharmaceutical companies, marketing agencies, publishing firms
Employer & Industry UsageReview clinical data, regulatory documents, ensuring accuracyCreate scientific content, clinical study reports, marketing materials

Medical Reviewers primarily verify the accuracy and compliance of clinical and regulatory documents, requiring medical credentials. Medical Writers focus on creating clear, accurate scientific content, often with a background in life sciences. Both roles are essential in the healthcare and pharmaceutical industries but serve different functions in the documentation process.

How do you become a medical reviewer?

To become a medical reviewer, candidates typically need a medical degree such as an MD or DO, along with clinical experience in a relevant healthcare field. Additional qualifications may include knowledge of medical guidelines, strong analytical skills, and familiarity with medical documentation and coding; some roles also require certification or training in medical review processes.
More about Medical Reviewer jobs
What cities are hiring for Medical Reviewer jobs? Cities with the most Medical Reviewer job openings:
What are the most commonly searched types of Medical Reviewer jobs? The most popular types of Medical Reviewer jobs are:
Who are the top companies hiring for Medical Reviewer jobs? The top employers for Medical Reviewer jobs are:
What states have the most Medical Reviewer jobs? States with the most job openings for Medical Reviewer jobs include:
What job categories do people searching Medical Reviewer jobs look for? The top searched job categories for Medical Reviewer jobs are:
What are popular job titles related to Medical Reviewer jobs? For Medical Reviewer jobs, the most frequently searched job titles are:
Medical Reviewer jobs near you
Infographic showing various Medical Reviewer job openings in the United States as of June 2026, with employment types broken down into 67% Full Time, and 33% Contract. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.
Medical Reviewer

Medical Reviewer

Community Health Network of Connecticut, Inc.

Wallingford, CT • On-site

$174K - $249K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP).

  • Participates and contributes in medical matters related to utilization management, case management, peer review, and quality improvement processes.

  • Responds to inquiries from providers, internal stakeholders, and the Department of Social Services as necessary.

Job description

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Medical Reviewer.

Primary Responsibilities:

  • Under the general direction of the Vice President of Clinical Affairs, performs medical case review of services subject to approval under the Connecticut Medical Assistance Program (CMAP).
  • Participates and contributes actively in medical matters related to utilization management, case management, peer review, quality improvement and other processes requiring medical/clinical leadership and consultation.
  • Responds to inquiries from providers, internal stakeholders, and Department of Social Services as necessary.
  • Serves as a resource to CHNCT clinical staff.
  • Provides recommendations for improving care delivery and health outcomes for CMAP enrollees.
  • Participates in activities specific to contractual requirements such as Fair Hearings, etc.

Tasks Performed:

  • Appropriately documents case review findings, actions, and outcomes in keeping with established policies.
  • Collaborates with clinical staff to implement clinical and quality management programs and initiatives.
  • Interacts with providers and vendors regarding clinical care and services for CMAP enrollees.
  • Actively participates and contributes in medical review team meetings; participates in design and development of care programs and quality improvement initiatives as requested.

Essential Functions:

  • Engages in telephonic case review and discussion with providers.
  • Proactively shares resources, information and guidelines related to quality, cost-effective health care delivery.
  • Shares best practices with other Medical Reviewers, CHNCT clinical staff.
  • Applies performance data to guide interactions and inform discussions with stakeholders.
  • Maintains a high level of productivity; adheres to ASO contract standards regarding timeliness of reviews and appeals.
  • Consistently meets plan inter­rater reliability guidelines.
  • Required to attend Medical Reviewer Staff Meetings via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings.
  • Required to be available for all training/retraining sessions via phone or in person unless vacation, illness or other extenuating circumstances that prevents the Medical Reviewer to attend these meetings. Note: training and retraining sessions may vary from year to year depending on assessment and need.
  • Required to attend all mandatory training provided by DSS.
  • Must comply with completing all company required trainings.

Desired Education: Medical School

Desired Degree: Medical Doctor or Doctor of Osteopathy

Desired Major: Primary care specialty

Desired Job Experience: Minimum 2 years as a Medical Reviewer or physician consultant in a managed care company preferred. Experience in Utilization Management, Case and Disease Management, preferably with Medicaid populations. Clinical experience in managing a range o1 pathologies and populations and up-to-date knowledge of evidence-based medical guidelines and accepted standards of care for managing the treatments, procedures, conditions, and diseases under review by CHNCT.

Other Qualifications: M.D. or D.O. current, non-restricted Connecticut license and Board certification. Flexible and able to adapt to altered work processes, technologies, and directives.

Certifications Required: Physician; Surgeon

CHNCT Offers Great Benefits:

  • Medical, dental and vision coverage options
  • Flexible spending and health savings accounts
  • Group term life insurance
  • A 401(k) plan with company-match and immediate vesting
  • Voluntary accidental injury coverage
  • Tuition reimbursement and continuing education opportunities
  • A generous paid-leave bank and company holidays
  • Wellness program

We are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment.

We are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.