Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Responsible for conducting timely reviews of all requests for services required to meet medical necessity criteria to include reviewing pre-certification for outpatient and inpatient services.
Clinical Care Reviewer
Des Moines, IA · On-site
Responsible for conducting timely reviews of all requests for services required to meet medical necessity criteria to include reviewing pre-certification for outpatient and inpatient services.
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer RN
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer RN
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer RN
Des Moines, IA · On-site
Job Summary Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse ...
Clinical Care Reviewer RN
Des Moines, IA · On-site
Job Summary Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Performs routine medical testing to provide data for use in diagnosis and treatment of patient ... Reviews reference laboratory reports for accuracy before the electronic release of the report.
Performs routine medical testing to provide data for use in diagnosis and treatment of patient ... Reviews reference laboratory reports for accuracy before the electronic release of the report.
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * Using clinical knowledge and nursing experience, the nurse reviews ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * Using clinical knowledge and nursing experience, the nurse reviews ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...
Performs routine medical testing to provide data for use in diagnosis and treatment of patient ... Reviews reference laboratory reports for accuracy before the electronic release of the report.
Performs routine medical testing to provide data for use in diagnosis and treatment of patient ... Reviews reference laboratory reports for accuracy before the electronic release of the report.
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * sing clinical knowledge and nursing experience, the nurse reviews ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * sing clinical knowledge and nursing experience, the nurse reviews ...
Esrun Health is seeking Medical Assistants to work part-time from their home office as independent ... Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ...
Esrun Health is seeking Medical Assistants to work part-time from their home office as independent ... Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ...
Direct medical review activities across assigned contracts * Serve as the subject matter expert on peer review processes * Articulate Telligen's policies to diverse medical and non-medical audiences ...
Direct medical review activities across assigned contracts * Serve as the subject matter expert on peer review processes * Articulate Telligen's policies to diverse medical and non-medical audiences ...
Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $96/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $96/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Physician Reviewer-Radiology (Part Time)
Des Moines, IA · On-site
$95 - $100/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Physician Reviewer-Radiology (Part Time)
Des Moines, IA · On-site
$95 - $100/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective ...
Rheumatologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Rheumatologist-Physician Reviewer-Radiology (Full-Time)
Des Moines, IA · On-site
$95 - $109/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Medical Reviewer information
See Iowa salary details
$11.06 - $18.64
14% of jobs
$22.80 is the 25th percentile. Wages below this are outliers.
$18.64 - $26.21
21% of jobs
The median wage is $30.13 / hr.
$26.21 - $33.79
30% of jobs
$33.79 - $41.36
9% of jobs
$43.88 is the 75th percentile. Wages above this are outliers.
$41.36 - $48.93
3% of jobs
$48.93 - $56.51
13% of jobs
$56.51 - $64.08
1% of jobs
$64.08 - $71.66
4% of jobs
$71.66 - $79.23
0% of jobs
$79.23 - $86.80
0% of jobs
$86.80 - $94.38
5% of jobs
$11
$39
$94
How much do medical reviewer jobs pay per hour?
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 are the key skills and qualifications needed to thrive as a medical reviewer, and why are they important?
How does a medical reviewer typically collaborate with other departments during the drug approval process?
What is the difference between Medical Reviewer vs Medical Writer?
| Aspect | Medical Reviewer | Medical Writer |
|---|---|---|
| Required Credentials | Medical degree (MD, DO, PharmD), licensure often preferred | Background in life sciences, writing skills, often with a degree in related fields |
| Work Environment | Pharmaceutical companies, CROs, regulatory agencies, hospitals | Pharmaceutical companies, marketing agencies, publishing firms |
| Employer & Industry Usage | Review clinical data, regulatory documents, ensuring accuracy | Create 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.
What are the most commonly searched types of Medical Reviewer jobs in Iowa?
The most popular types of Medical Reviewer jobs in Iowa are:
What are popular job titles related to Medical Reviewer jobs in Iowa?
For Medical Reviewer jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Medical Reviewer jobs in Iowa look for?
The top searched job categories for Medical Reviewer jobs in Iowa are:
What are popular job titles related to Medical Reviewer jobs in IA?
For Medical Reviewer jobs in IA, the most frequently searched job titles are:

Medicare Appeals Reviewer I (Dispute Resolution Reviewer I)
Des Moines, IA • On-site
Other
This job post has expired today. Applications are no longer accepted.
Job description
Medicare Appeals Reviewer I (Dispute Resolution Reviewer I)
Fully Remote•United States
Job Type
Full-time
Description
Overview
Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TSS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders.
About the Role
We are seeking a Medicare Appeals Reviewer I (Dispute Resolution Reviewer I) to support our federal client. In this role, you will review Medicare enrollment appeal and rebuttal cases, evaluate supporting documentation and evidence, and issue independent determinations based on applicable laws, regulations, policies, and guidelines.
This role will work under general supervision, with moderate latitude for initiative and independent judgment.
This is a remote position that can be based anywhere in the United States; candidates must reside in the United States. Must be able to work on a rotating schedule on weekends and holidays.
Responsibilities
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Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review
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Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy
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Responds to and ensures that all issues raised by the beneficiary, representative, supplier, and provider have been addressed
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Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures
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Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision
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Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures
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Participates in special projects and performs other duties as assigned
Requirements
Required Experience and Skills
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One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting
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Knowledge and experience following HIPAA regulations and personally identifiable information (PII).
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Experience using Microsoft 365, including Excel and Word.
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Must be able to pass Federal and state criminal background checks, as required by client.
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Must be able to pass a drug screen, as required by the client.
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Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
Preferred Qualifications
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Experience working within the federal public health agency environment.
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Experience in appeals and billing.
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Previous CMS guidelines or manual knowledge, particularly with the No Surprises Act.
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Medical Coding certified.
Education and Training
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Associate’s degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in healthcare or related discipline.
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Experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for an Associate’s degree on a year-for-year basis (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent)
Physical Requirements
- Prolonged periods of sitting at a desk and working on a computer. May need to lift 25 pounds occasionally.
Who We Are
Tanaq Support Services (TSS) is a public health contractor, certified 8(a) business, owned by St. George Tanaq Corporation, an Alaska Native Corporation. (ANC). We listen to our stakeholders and leverage our science, technology, communication, and program expertise to understand and provide feedback as we develop solutions.
Our Commitment to Non-Discrimination
Tanaq Support Services is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to disability, status as a protected veteran or any other status protected by applicable federal, state, or local law. Tanaq complies with the Drug-free Workplace Act of 1988 and E-Verify.
If you are an individual with a disability and need assistance completing any part of the application process, please email accommodation@tanaq.com to request a reasonable accommodation. This email is for accommodation requests only and cannot be used to inquire about the status of applications.
Notice on Candidate AI Usage
Tanaq is committed to ensuring a fair and competitive interview process for all candidates based on their experience, skills and education. To ensure the integrity of the interview process, the use of artificial intelligence (AI) tools to generate or assist with responses during phone, in person and virtual interviews is not allowed. However, candidates who require a reasonable accommodation that may involve AI are required to contact us prior to their interview at accommodation@tanaq.com.
To view this and all our job postings, visit us at:
https://recruiting.paylocity.com/recruiting/jobs/All/a4712c9f-f074-40e8-9a14-bee06660bd81/Tanaq-Support-Services-LLC
About St. George Tanaq
Sourced by ZipRecruiter
Industry
Business management consulting
Company size
1 - 10 Employees
Headquarters location
Anchorage, AK, US
Year founded
1973