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Remote Medical Reviewer Jobs in Riverside, CA (NOW HIRING)

All Care To You

Medical Billing Team Lead

Orange, CA · Remote

$22 - $26/hr

Our company is fully remote and offers a flexible work environment as well as schedules. ACTY ... Review complex patient accounts requiring identification of duplicate claims, corrected claims ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

... treatment, certifies the medical necessity and assigns an appropriate length of stay while ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...

All Care To You

Medical Billing Coordinator

Orange, CA · Remote

$18 - $22/hr

Our company is fully remote and offers a flexible work environment as well as schedules. ACTY ... Reviews incoming correspondence from health plans and takes appropriate action or escalates to ...

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All JobsRemote Medical Reviewer JobsRemote Medical Reviewer Jobs in Riverside, CA

Remote Medical Reviewer information

See Riverside, CA salary details

$12

$43

$104

How much do remote medical reviewer jobs pay per hour?

As of Jun 27, 2026, the average hourly pay for remote medical reviewer in Riverside, CA is $43.88, according to ZipRecruiter salary data. Most workers in this role earn between $23.85 and $56.44 per hour, depending on experience, location, and employer.

What is a Remote Medical Reviewer job?

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 in the Remote Medical Reviewer position, and why are they important?

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.

What are popular job titles related to Remote Medical Reviewer jobs in Riverside, CA? For Remote Medical Reviewer jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Medical Reviewer jobs in Riverside, CA look for? The top searched job categories for Remote Medical Reviewer jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Medical Reviewer jobs? Cities near Riverside, CA with the most Remote Medical Reviewer job openings:
Remote Medical Reviewer jobs near you
Medical Director job in Pomona CA

Medical Director job in Pomona CA

Inspire Healthcare

Pomona, CA • Remote

$250K - $350K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the LAarea and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

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