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Medical Reviewer Jobs in Virginia (NOW HIRING)

Peraton

Nurse Reviewer - Medicaid

Reston, VA · On-site

$66K - $106K/yr

The Medical Reviewer requires the individual to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions. Responsibilities may include additional research on ...

Peraton

Nurse Reviewer - Medicaid

Herndon, VA · On-site

$66K - $106K/yr

The Medical Reviewer requires the individual to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions. Responsibilities may include additional research on ...

US Bank

Reviewer Appraiser

Mclean, VA

$34.57 - $46.11/hr

Reviews appraisals and reports including desktop valuations from a wide variety of bank channels ... Our benefits include the following: * Healthcare (medical, dental, vision) * Basic term and ...

Kedrion S.p.A.

Medical Screener

Hampton, VA · On-site

Guide donors through the health screening process, including reviewing self-administered health history forms and determining if further medical review is needed. * Perform vital signs assessments ...

Kedrion S.p.A.

Medical Screener

Hampton, VA · On-site

Guide donors through the health screening process, including reviewing self-administered health history forms and determining if further medical review is needed. * Perform vital signs assessments ...

KEDPlasma USA

Medical Screener

Hampton, VA

Guide donors through the health screening process, including reviewing self-administered health history forms and determining if further medical review is needed. * Perform vital signs assessments ...

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Medical Reviewer information

See Virginia salary details

$11

$41

$99

How much do medical reviewer jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for medical reviewer in Virginia is $41.70, according to ZipRecruiter salary data. Most workers in this role earn between $22.64 and $53.61 per hour, depending on experience, location, and employer.

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?

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.

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 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 Virginia?

The most popular types of Medical Reviewer jobs in Virginia are:

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For Medical Reviewer jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Medical Reviewer jobs in Virginia look for?

The top searched job categories for Medical Reviewer jobs in Virginia are:

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Cities in Virginia with the most Medical Reviewer job openings:

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For Medical Reviewer jobs in VA, the most frequently searched job titles are:

Medical Reviewer jobs near you
Infographic showing various Medical Reviewer job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 54% In-person, and 46% Remote job distribution, with an average salary of $86,726 per year, or $41.7 per hour.

Nurse Reviewer - Medicaid

Peraton

Reston, VA • On-site

$66K - $106K/yr

Other

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

Peraton rating

8.3

Company rating: 8.3 out of 10

Based on 56 frontline employees who took The Breakroom Quiz

51st of 226 rated it services

Job description


Nurse Reviewer - Medicaid
Job Locations
US
Requisition ID
2026-169510
Position Category
Business Controls
Clearance
No Clearance Required
Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add a Medical Reviewer to our SGS team of talented professionals.

What you'll do:

The Medical Reviewer requires the individual to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions.

Responsibilities may include additional research on medical claims data and other sources of information to identify problems, review sophisticated data model output, and utilize a variety of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information. The incumbent will use a variety of tools to identify and develop cases for future administrative action, including referral to law enforcement, education, over payment recovery. Will work with external agencies to develop cases and corrective actions as well as respond to requests for data and support.

Roles and Responsibilities:

    Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
  • Research regulations and cite violations.
  • Conduct self-directed research to uncover problems in Medicaid payments made to institutional and non-institutional providers.
  • Make claim payment decisions based on clinical knowledge
  • This position may require the incumbent to appear in court to testify about work findings.
  • Ability to compose correspondence, reports, and referral summary letters.
  • Ability to communicate effectively, internally and externally.
  • Ability to handle confidential material.
  • Ability to report work activity on a timely basis.
  • Ability to work independently and as a member of a team to deliver high quality work.
  • Ability to attend meetings, trainings, and conferences as needed. Overnight travel may be required.
  • Telework available from contiguous United States.

Qualifications

Basic Qualifications:

  • Bachelors and 5 years of experience, Masters degree and 3 years of experience, Associates and 7 years of experience
  • At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity.
  • Current/Active Nursing or Physical Therapy license in state of residence.
  • Strong investigative skills
  • Strong communication and organization skills
  • Strong PC knowledge and skills
  • U.S. citizenship required

Desirable Qualifications:

  • Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
  • Knowledge of Medicaid requirements, laws, rules and regulations related to payment for services billed
  • Have a CPC (Certified Professional Coder) certificate.

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure.

Target Salary Range
$66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
EEO
EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.

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About Peraton

Sourced by ZipRecruiter

At Peraton, we re at the forefront of delivering the next big thing every day. We re the partner of choice to help solve some of the world s most daunting challenges, delivering bold, new solutions to keep people around the world safer and more secure.

Industry

It services

Company size

10,000+ Employees

Headquarters location

Herndon, VA, US

Year founded

2017

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