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Medicare Reviewer Jobs (NOW HIRING)

Empress EMS

Sr Medicare Biller

Yonkers, NY · On-site

$63K/yr

Process, review, and submit Medicare claims for emergency and non-emergency ambulance services in accordance with CMS and New York State regulations * Ensure accurate coding, modifiers, mileage, and ...

Ourhrconnect

Medical Reviewer II

Carolina, RI · On-site +1

Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross ... Perform medical claim reviews for one or more of the following: claims for medically complex ...

Ourhrconnect

Medical Reviewer II

Alabama, NY · On-site +1

Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross ... Perform medical claim reviews for one or more of the following: claims for medically complex ...

Ourhrconnect

Medical Reviewer II

Alabama, NY · On-site +1

Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross ... Perform medical claim reviews for one or more of the following: claims for medically complex ...

Ourhrconnect

Medical Reviewer II

Carolina, RI · On-site +1

Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross ... Perform medical claim reviews for one or more of the following: claims for medically complex ...

Barrow Wise Consulting

Medicare Analyst

MD · On-site

$70K - $90K/yr

Review and assess the current Medicare Part A & B, claiming policies, procedures, practices, and outcomes of each State-operated facility for mental health and developmental disabilities * Assist the ...

Verisk

MSA Nurse Reviewer

Bradenton, FL · On-site

We are seeking a MSA Nurse Reviewer with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate ...

Optalis Healthcare

MDS Nurse

Dearborn Heights, MI · On-site

$33 - $43/hr

Tracks Validation Reports, Monthly and Quarterly Reports from the state. II. Medicare Review and Coverage * Active interaction with the Interdisciplinary Team in daily conference to evaluate each ...

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Medicare Reviewer information

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$29

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How much do medicare reviewer jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for medicare reviewer in the United States is $29.88, according to ZipRecruiter salary data. Most workers in this role earn between $22.60 and $36.54 per hour, depending on experience, location, and employer.

How do you become a medical reviewer?

To become a Medicare reviewer, candidates typically need a medical degree such as an MD or DO, along with clinical experience. Additional qualifications often include knowledge of Medicare policies, strong analytical skills, and sometimes certification in healthcare compliance or coding; familiarity with medical record review tools is also beneficial.

What jobs pay 2000 a day?

High-paying roles such as Medicare reviewers typically do not earn $2,000 per day; most healthcare or administrative jobs pay less. Positions that can reach this level often involve specialized consulting, executive roles, or highly experienced professionals in finance, law, or technology, often requiring advanced certifications and significant expertise. Such earnings are usually associated with freelance consulting, executive management, or specialized medical consulting rather than standard employment roles.

What are the common challenges faced by Medicare Reviewers in their daily work?

Medicare Reviewers often encounter the challenge of interpreting complex medical documentation and ensuring claims meet evolving Medicare guidelines. The role requires staying current on frequently changing regulations, which demands ongoing learning and adaptability. Balancing efficiency with accuracy is crucial, as reviewers may handle a high volume of cases with varying complexity. Collaborating with medical providers, billing teams, and compliance staff is a regular part of the job, which enhances accuracy but can introduce coordination challenges. Despite these hurdles, many Medicare Reviewers find the work rewarding as it directly impacts patient care quality and healthcare cost management.

How to become a Medicare reviewer?

To become a Medicare reviewer, candidates typically need a background in healthcare, such as nursing, medical coding, or health administration, along with knowledge of Medicare policies. Relevant certifications like Certified Professional Coder (CPC) or healthcare compliance credentials can enhance prospects. Experience with medical records review and familiarity with healthcare software are also beneficial.

What is a Medicare Reviewer job?

A Medicare Reviewer is responsible for evaluating medical claims, patient records, and healthcare services to ensure they meet Medicare guidelines and regulations. They analyze documentation to determine medical necessity, accuracy, and compliance with federal policies. Medicare Reviewers may work for government agencies, private insurance companies, or healthcare organizations to prevent fraud and ensure proper billing. Strong attention to detail, knowledge of Medicare policies, and experience in medical coding or auditing are essential for this role.

What are the key skills and qualifications needed to thrive in the Medicare Reviewer position, and why are they important?

A successful Medicare Reviewer typically holds a healthcare-related degree and possesses a deep understanding of Medicare regulations, coding guidelines, and medical terminology. Experience with claims processing software, electronic health records (EHRs), and knowledge of CMS guidelines or certifications such as Certified Professional Coder (CPC) are often required. Strong attention to detail, analytical thinking, and clear written communication are essential soft skills in this role. Together, these skills ensure accurate claims evaluation, regulatory compliance, and effective communication with providers and payers.

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

A Medicare reviewer typically earns between $3,000 and $6,000 per month, which is below $10,000. Jobs that can pay $10,000 or more monthly without a degree often include high-level sales roles, real estate agents with successful transactions, or specialized trades like certain construction or technical positions, but these usually require experience, certifications, or licenses rather than formal degrees.
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What are the most commonly searched types of Medicare Reviewer jobs? The most popular types of Medicare Reviewer jobs are:
What states have the most Medicare Reviewer jobs? States with the most job openings for Medicare Reviewer jobs include:
What job categories do people searching Medicare Reviewer jobs look for? The top searched job categories for Medicare Reviewer jobs are:
Medicare Reviewer jobs near you

Experienced Medicare Sales Representative Remote

INSURE CHOICE LLC

Austin, TX • Remote

$20/hr

Full-time

Medical, Dental, Vision, Life

Posted 12 days ago

Job description


Role Summary


We are seeking experienced, licensed Medicare Sales Agents to join our remote team. In this role, you will work under the guidance of a dedicated sales manager and team leadership, receiving ongoing coaching, performance support, and oversight. You will guide Medicare-eligible beneficiaries through plan options — including Medicare Advantage, Medicare Supplement, and Part D — while cross-selling ancillary products such as Hospital Indemnity Insurance (HII), dental, vision, hearing, and final expense coverage. Candidates must be able to provide carrier releases from all current carrier appointments prior to or during onboarding.

Key Responsibilities

•        Work within a managed team structure, participating in regular coaching sessions, performance reviews, and team meetings led by              your sales manager
•        Conduct inbound and outbound calls with Medicare-eligible beneficiaries to assess coverage needs
•        Present, compare, and enroll beneficiaries in Medicare Advantage, Supplement (Medigap), and Part D plans
•        Cross-sell Hospital Indemnity Insurance (HII) and ancillary products including dental, vision, hearing, and final expense to maximize              client coverage and attachment rates
•        Educate clients on the benefits of HII as a gap-coverage complement to Medicare Advantage plans
•        Obtain and submit carrier releases from all current carrier appointments prior to or during onboarding
•        Maintain compliance with CMS regulations, HIPAA requirements, and all carrier guidelines
•        Manage leads, follow-ups, and enrollment documentation within the company CRM
•        Meet or exceed monthly enrollment goals, ancillary attachment targets, and retention metrics set by management
•        Stay current on plan updates, formulary changes, and Medicare AEP/OEP requirements

Requirements

•        3+ years of Medicare sales experience — must be verifiable and active within the last 6 months
•        Must be able to provide carrier releases from all current carrier appointments before or during onboarding
•        Proven experience selling HII and ancillary products alongside Medicare plans
•        Comfortable working within a managed structure with regular reporting, coaching, and oversight from a sales manager
•        Active state health insurance license (Life & Health or equivalent)
•        Completed AHIP certification (current year preferred)
•        Solid knowledge of Medicare Part A, B, C (Advantage), D, and how ancillary products complement each
•        Reliable high-speed internet, dedicated home workspace, and a computer meeting system requirements
•        Consultative, compliance-first sales approach with strong communication skills


Preferred Qualifications


•        Experience across multiple ancillary lines — DVH, final expense, cancer/critical illness, or accident plans
•        Multi-state licensure
•        Experience with Medicare quoting platforms 
•        Proven track record of high ancillary attachment rates alongside Medicare enrollments
•        Bilingual (English/Spanish) a strong plus

This is a full-time, permanent role with consistent hours, base pay, and strong commission potential.
Base pay is $20 per hour plus commission.
ONLY APPLY IF YOU CURRENTLY HOLD AN ACTIVE HEALTH INSURANCE LICENSE

We look forward to welcoming a passionate Medicare Sales Representative who is eager to contribute to our team's success!