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Remote Medical Reviewer information

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$11

$41

$99

How much do remote medical reviewer jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for remote medical reviewer in California is $41.51, according to ZipRecruiter salary data. Most workers in this role earn between $22.55 and $53.37 per hour, depending on experience, location, and employer.

What is a remote medical reviewer?

A Remote Medical Reviewer evaluates medical records, claims, or cases to ensure accuracy, compliance, and appropriate medical decision-making. They typically work for insurance companies, healthcare organizations, or third-party review agencies. This role involves analyzing documentation, applying clinical guidelines, and providing recommendations based on medical expertise. It requires a background in healthcare, such as nursing or medicine, along with strong analytical and communication skills. The job is performed remotely, allowing flexibility while maintaining high standards of medical review.

What are the key skills and qualifications needed to thrive as a remote medical reviewer?

A Remote Medical Reviewer requires a strong background in healthcare, such as a nursing or pharmaceutical degree, along with in-depth knowledge of clinical guidelines and regulatory standards. Familiarity with electronic medical record (EMR) systems, coding software, and industry certifications like RHIA or CCS is often necessary. Exceptional attention to detail, analytical thinking, and clear written communication are vital soft skills for this role. These competencies ensure accurate and timely medical review decisions that impact patient care and regulatory compliance.

What are some common challenges faced by remote medical reviewers and how can they be addressed?

Remote Medical Reviewers often encounter challenges such as reviewing complex cases with limited background information and keeping up with frequent updates to medical regulations and insurance policies. Staying organized, participating in continuing education, and leveraging robust digital communication tools can help you overcome these obstacles. You'll also need to be self-motivated and comfortable working independently, as remote teams often collaborate primarily through virtual meetings and secure documentation platforms. Embracing strong time management practices and regularly connecting with colleagues for case discussions can greatly enhance your job performance and satisfaction.

How to become a remote medical reviewer?

To become a remote medical reviewer, candidates typically need a medical degree such as MD or DO, along with clinical experience in a relevant specialty. Strong analytical skills, attention to detail, and familiarity with medical records and documentation are essential, and some positions may require certification or licensure in the relevant state or country. Proficiency with electronic health records (EHR) systems and the ability to work independently are also important for remote roles.

What are the most commonly searched types of Medical Reviewer jobs in California?

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

What are popular job titles related to Remote Medical Reviewer jobs in California?

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

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

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

What cities in California are hiring for Remote Medical Reviewer jobs?

Cities in California with the most Remote Medical Reviewer job openings:

Remote Medical Reviewer jobs near you
Infographic showing various Remote Medical Reviewer job openings in California as of August 2026, with employment types broken down into 60% Full Time, and 40% Contract. Highlights an 100% Remote job distribution, with an average salary of $86,331 per year, or $41.5 per hour.

Medical Reviewer (Physician) - Remote CA

Gainwell Technologies LLC

West Sacramento, CA • Remote

$140K - $160K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 17 hours ago

Posted today

Gainwell Technologies rating

7.8

Company rating: 7.8 out of 10

Based on 82 frontline employees who took The Breakroom Quiz

139th of 246 rated software companies

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies is seeking a Medical Reviewer (Physician) to support Medical Review Services for California healthcare programs. This role provides physician-level clinical expertise supporting medical policy, claim adjudication, Treatment Authorization Requests (TARs), appeals, provider-related medical review activities, and other healthcare program requirements.

Your role in our mission
  • Perform physician-level medical reviews of claims, TARs, appeals, and other clinical documentation.
  • Apply medical expertise, applicable policies, coverage requirements, and clinical standards when making or supporting review determinations.
  • Provide technical and clinical expertise related to suspended claims, appeals, provider inquiries, and other medical review activities.
  • Support medical policy interpretation and development as needed.
  • Provide clinical expertise supporting drug utilization review when assigned.
  • Document medical review findings and clinical rationale clearly and accurately.
  • Collaborate with pharmacists, nurses, other clinicians, operations teams, and business partners.
  • Maintain knowledge of applicable Medicaid, Medicare, California healthcare program, and regulatory requirements.
  • Meet established quality, accuracy, productivity, and timeliness standards.
What we're looking for
  • Current, non-expired physician license from the State of California, in good standing.
  • Must not be under suspension from Medicare, Medicaid, or the practice of medicine in California.
  • Must not have been previously sanctioned for fraud or abuse.
  • Three (3) years of experience as a medical consultant for a government or private-sector healthcare payer; or one (1) year of MMIS experience providing technical expertise and assistance for the entire suspended claims process, appeals process, and provider relations; or three (3) years of experience in drug utilization review.
  • Strong oral and written communication skills.
  • Strong clinical judgment and ability to interpret complex medical documentation.
What you should expect in this role
  • Full-time position.
  • Remote work environment.
  • Monday through Friday work schedule.
  • Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
  • Spend the majority of your day reviewing medical, clinical, claim, authorization, and/or supporting documentation relevant to your area of expertise.
  • Work independently while collaborating with physicians, pharmacists, nurses, other clinical specialists, operations teams, and business partners.
  • Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
  • Maintain all professional licenses, certifications, and credentials required for the position in active, unrestricted, and good-standing status, as applicable.
  • Maintain knowledge of applicable medical policies, coverage requirements, clinical standards, and regulatory guidelines.
  • Meet established quality, accuracy, productivity, and turnaround-time expectations.
  • Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.
  • Travel requirement: 0-10%.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis.

#LI-REMOTE

#LI-MA1

The pay range for this position is $140,000 - $160,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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