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Medical Reviewer Jobs in Delaware (NOW HIRING)

Elevance Health

Nurse Reviewer 1

Wilmington, DE · On-site

Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.

Elevance Health

Nurse Reviewer 1

Wilmington, DE

Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.

Georgetown Medical Associates

Medical Doctor

Milford, DE · On-site

$250K/yr

... Reviews; • Perform diagnostic tests and procedures and therapeutic procedures, within the scope ... Qualifications: · Medical degree (M.D. or D.O.) · License to practice medicine · Board ...

Georgetown Medical Associates

Medical Doctor

Milford, DE · On-site

$250K/yr

... Reviews; • Perform diagnostic tests and procedures and therapeutic procedures, within the scope ... Qualifications: · Medical degree (M.D. or D.O.) · License to practice medicine · Board ...

Simon Eye Associates

Medical Billing Specialist

Wilmington, DE · On-site

$17.75 - $22.75/hr

As a Medical Billing Specialist , you will be responsible for the insurance billing and collections ... Review, prepare, and transmit claims using electronic and paper claim processing * Daily submission ...

Simon Eye Associates

Medical Billing Specialist

Wilmington, DE · On-site

$17.75 - $22.75/hr

As a Medical Billing Specialist , you will be responsible for the insurance billing and collections ... Review, prepare, and transmit claims using electronic and paper claim processing * Daily submission ...

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All JobsMedical Reviewer JobsMedical Reviewer Jobs in Delaware

Medical Reviewer information

See Delaware salary details

$11

$42

$100

How much do medical reviewer jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for medical reviewer in Delaware is $42.09, according to ZipRecruiter salary data. Most workers in this role earn between $22.84 and $54.13 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 is the role of a medical reviewer?

A medical reviewer evaluates medical records, clinical data, and healthcare documentation to ensure accuracy, compliance, and quality. They often work in healthcare, insurance, or pharmaceutical settings, requiring medical knowledge, attention to detail, and sometimes licensure or certification in a healthcare field.

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 skills do you need to be a medical reviewer?

A medical reviewer needs strong clinical knowledge, typically requiring a healthcare background such as a nursing or medical degree. Excellent attention to detail, critical thinking, and familiarity with medical documentation and regulations are essential, along with good communication skills and proficiency with medical review tools or software.

What is the 3 month rule for jobs?

The 3 month rule for medical reviewers typically refers to a probationary period of three months during which performance and accuracy are closely monitored. This period allows employers to assess skills, adherence to guidelines, and reliability before offering permanent employment or benefits.

How to 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 specialty. Additional qualifications may include knowledge of medical guidelines, strong analytical skills, and familiarity with medical documentation and review processes. Certification or training in medical review or healthcare compliance can also enhance job prospects.

What is a medical reviewer?

A medical reviewer is a healthcare professional, often a licensed physician or nurse, who evaluates medical records, claims, or documentation to ensure accuracy, compliance, and appropriate treatment. They typically review cases for insurance companies, healthcare organizations, or research studies and may require knowledge of medical coding and documentation standards.

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.

More about Medical Reviewer jobs
What are the most commonly searched types of Medical Reviewer jobs in Delaware? The most popular types of Medical Reviewer jobs in Delaware are:
What are popular job titles related to Medical Reviewer jobs in Delaware? For Medical Reviewer jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Medical Reviewer jobs in Delaware look for? The top searched job categories for Medical Reviewer jobs in Delaware are:
What cities in Delaware are hiring for Medical Reviewer jobs? Cities in Delaware with the most Medical Reviewer job openings:
What are popular job titles related to Medical Reviewer jobs in DE? For Medical Reviewer jobs in DE, the most frequently searched job titles are:
Medical Reviewer jobs near you
Infographic showing various Medical Reviewer job openings in Delaware as of July 2026, with employment types broken down into 82% Full Time, 6% Part Time, and 12% Contract. Highlights an 100% In-person job distribution, with an average salary of $87,552 per year, or $42.1 per hour.
Otolaryn and Facial Plastic Surgery

Otolaryn and Facial Plastic Surgery

Dane Street

Dover, DE

Other

Posted 17 days ago

Job description

As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

    • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
    • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
    • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
    • Provides copies of any criteria utilized in a review with the report in a timely manner
    • Returns cases on or before the due date and time
    • Makes telephone calls as mandated by the state and/or client specifics
    • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
    • Attends all required orientation and training
    • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
  • Board certification required, active practice required

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. 

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.  

Apply