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Remote Medical Reviewer Jobs in Rochester, NY (NOW HIRING)

Deloitte

System Test and Validation Lead

Rochester, NY · On-site +1

... medical device, or clinical * Experience leading validation deliverables for GxP systems, including ... Experience supporting periodic review programs for validated systems and associated CAPA triggers

Deloitte

System Test and Validation Lead

Rochester, NY · On-site +1

... medical device, or clinical * Experience leading validation deliverables for GxP systems, including ... Experience supporting periodic review programs for validated systems and associated CAPA triggers

Deloitte

System Test and Validation Lead

Rochester, NY · On-site +1

... medical device, or clinical * Experience leading validation deliverables for GxP systems, including ... Experience supporting periodic review programs for validated systems and associated CAPA triggers

Livingston Associates

BIM/VDC Manager

Rochester, NY · On-site +1

$80K - $100K/yr

Review models to ensure adherence to company and project standards * Contribute to the development ... Remote work opportunities available Why Join Hale TIP? * Work on cutting-edge construction ...

Rochester Regional Health

Coder - Inpatient

Rochester, NY · On-site +1

$21.50 - $26/hr

SUMMARY Review clinical documentation and diagnostic results to extract data and apply appropriate ... Riedman- Remote SCHEDULE: Day shift ATTRIBUTES * Abides by the Standards of Ethical Coding as set ...

LaBella Associates

PV Designer - Renewables

Rochester, NY · On-site +1

$70K - $80K/yr

... remote/hybrid work a possibility. The Renewables Team at LaBella focuses on designing and ... Review project drawings and documentation. * Calculate and design PV stringing layout. * Size ...

MasTec Industrial

Engineer, E&I

Rochester, NY · On-site +1

$140K - $180K/yr

This is a remote role and can be based anywhere in the United States. Must be able to travel up to ... Review RFP/RFQ/Contract packages for technical requirements * Prepare and maintain proposal ...

Webbing

CSM Team Lead

York, NY · On-site +1

... Reviews, anticipating customer risks, coaching team members, and serving as the voice of the ... Fully remote role * Medical benefits

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Showing results 21-40

All JobsMedical Reviewer JobsRemote Medical Reviewer JobsRemote Medical Reviewer Jobs in Rochester, NY

Remote Medical Reviewer information

See Rochester, NY salary details

$11

$41

$99

How much do remote medical reviewer jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for remote medical reviewer in Rochester, NY is $41.50, 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.

What are the most commonly searched types of Medical Reviewer jobs in Rochester, NY? The most popular types of Medical Reviewer jobs in Rochester, NY are:
What are popular job titles related to Remote Medical Reviewer jobs in Rochester, NY? For Remote Medical Reviewer jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Remote Medical Reviewer jobs in Rochester, NY look for? The top searched job categories for Remote Medical Reviewer jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Remote Medical Reviewer jobs? Cities near Rochester, NY with the most Remote Medical Reviewer job openings:
Remote Medical Reviewer jobs near you
Infographic showing various Remote Medical Reviewer job openings in Rochester, NY as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $86,310 per year, or $41.5 per hour.

Clinical DRG Denials Specialist

Rochester Regional Health

Rochester, NY • On-site, Remote

$37.50 - $43.25/hr

Part-time

This job post has expired 1 day ago. Applications are no longer accepted.

Rochester Regional Health rating

7.3

Company rating: 7.3 out of 10

Based on 218 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

Job description

Job Title: Clinical DRG Denial Specialist
Location: Remote
Schedule: Per Diem
SUMMARY:
The Clinical DRG Denials Specialist applies clinical knowledge, coding principles, payer policy interpretation, and documentation review to support appropriate reimbursement and regulatory compliance and works to protect organizational reimbursement by ensuring the accurate review, appeal, and resolution of DRG-related payer denials. Additionally, the position proactively works to identify documentation and coding risks before claim submission to reduce avoidable denials and strengthen revenue integrity. Through analysis of denial trends and appeal outcomes, the role helps improve processes and support denial prevention strategies across the revenue cycle.
RESPONSIBILITIES:
• Ensures accurate and timely resolution of DRG-related payer denials and audit activity in order to protect reimbursement and minimize avoidable revenue loss.
• Produces well-supported and compliant appeal outcomes by applying clinical, coding, and payer policy knowledge to disputed DRG determinations.
• Maintains adherence to contractual, regulatory, and documentation requirements across denial, appeal, and pre-bill review activities to support compliance and payment integrity.
• Strengthens revenue integrity by identifying and addressing documentation, coding, and medical necessity risks before claim submission.
• Improves denial prevention performance through analysis of payer trends, denial patterns, and appeal outcomes, leading to responsive strategies and process enhancements.
• Ensures denial-related information, requirements, and case status are consistently maintained to support accurate tracking, reconciliation, and operational visibility.
• Promotes effective, standardized denial and appeal practices that support efficient workflows and consistent organizational response to payer challenges.
• Applies specialized clinical and coding expertise to support accurate DRG assignment, documentation integrity, and sustainable reimbursement outcomes across the revenue cycle.
REQUIRED QUALIFICATIONS:
  • Degree in Nursing
  • NYS Registered Nurse Licensure

PREFERRED QUALIFICATIONS:
  • Knowledge of Epic preferred
  • Proficient in Microsoft Office applications preferred
  • Practical experience with computerized encoding and grouping software preferred
  • Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist certification (CCS) preferred.
  • BSN preferred.

EDUCATION:
LICENSES / CERTIFICATIONS:
PHYSICAL REQUIREMENTS:
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$37.50 - $43.25
CITY:
Rochester
POSTAL CODE:
14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

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