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Mindlance

Physician Reviewer

Remote Physician Medical Reviewer Pre-service reviews only. Training will be for 3-4 days per week for at least 4 weeks, Monday - Friday 8a-5pm [CST]. Seeking physician medical reviewer for remote ...

Tango Care

Physician Reviewer (Remote)

Phoenix, AZ · On-site +1

... with physicians to provide education, peer to peer reviews and support. Office Location: Remote - flexible hours Essential Functions: * Perform focused real-time case reviews by reviewing the ...

Integrated Resources

Physician Reviewer

$105/hr

Physician Reviewer Location: 100% Remote Duration: 2+ Years Contract Position+ Contract to Hire Schedule: 40hr, Mon- Fri, 8 am - 5.00 pm (Including - at least 2 weekends per month). Pay Rate: $105.00 ...

Med Review Inc

Physician Reviewer

This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced, data-driven environment. In this role, you will ...

VIVA

Physician Reviewer

Participates in the Physician Review Units' appeal process of service denials. Participates in the ... Notes: Position does not provide direct patient care or medical diagnosis.) Remote 20 - 40 hours ...

MedReview

Physician Reviewer

Manhattan, NY · On-site +1

This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced, data-driven environment. In this role, you will ...

MedReview

Physician Reviewer

Manhattan, NY · Remote

This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who thrives in a fast-paced, data-driven environment. In this role, you will ...

Managed Medical Review Organization

Position Overview As an Independent Physician Reviewer, you will perform objective medical record ... Why Partner with MMRO? * 100% remote independent contractor opportunity * Flexible scheduling with ...

Managed Medical Review Organization

Position Overview As an Independent Physician Reviewer, you will perform objective medical record ... Why Partner with MMRO? * 100% remote independent contractor opportunity * Flexible scheduling with ...

MMRO

Pain Management Physician Reviewer (Remote)

Position Overview As an Independent Physician Reviewer, you will perform objective medical record ... Why Partner with MMRO? * 100% remote independent contractor opportunity * Flexible scheduling with ...

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How much do remote physician reviewer jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote physician reviewer in the United States is $74.38, according to ZipRecruiter salary data. Most workers in this role earn between $48.08 and $91.11 per hour, depending on experience, location, and employer.

What is a remote physician reviewer?

A Remote Physician Reviewer is a licensed medical doctor who evaluates medical records, claims, or treatment plans from a remote location, typically for insurance companies, healthcare organizations, or government programs. Their main role is to ensure that medical decisions comply with clinical guidelines and regulatory standards without direct patient interaction. They review documentation to determine the medical necessity, appropriateness, and efficiency of healthcare services. This position allows physicians to leverage their clinical expertise in a non-clinical, flexible work environment. Remote Physician Reviewers often communicate their findings through written reports or recommendations.

What does a remote physician reviewer do?

As a remote physician reviewer, your job is to support an insurance company and evaluate patient records to determine whether or not a physician is regularly making good treatment decisions. In this role, you may check health plans to determine whether or not they cover the requested treatments, help process claims, and examine case files to ensure all relevant information is available. This is a remote job, so you can work from home and telecommute when you need to contact others. Remote physician reviewers frequently use critical thinking skills, suggest alternative treatments, and verify the accuracy of information added to the case management system.

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

To thrive as a Remote Physician Reviewer, you need an active medical license, board certification in your specialty, and thorough knowledge of clinical guidelines and medical terminology. Familiarity with utilization management software, electronic health records (EHRs), and secure telecommunication platforms is essential. Strong analytical skills, attention to detail, and clear written communication set outstanding candidates apart. These abilities ensure accurate, timely clinical reviews and effective collaboration with healthcare teams, supporting quality patient care and regulatory compliance.

What are some common challenges faced by remote physician reviewers, and how can they be effectively managed?

Remote physician reviewers often face challenges such as managing a high volume of case reviews, ensuring timely and accurate documentation, and maintaining clear communication with healthcare teams. Balancing workload while adhering to strict deadlines can be demanding, especially when working independently. To manage these challenges, it's important to establish a structured daily routine, utilize secure electronic health record systems efficiently, and stay proactive in seeking clarification or collaboration with colleagues when needed.

What is the difference between Remote Physician Reviewer vs Remote Medical Coder?

AspectRemote Physician ReviewerRemote Medical Coder
Required CredentialsMedical degree, medical license, clinical experienceCertification in coding (CPC, CCS), training in medical coding
Work EnvironmentHealthcare organizations, insurance companies, telehealth platformsHospitals, billing companies, insurance firms, remote offices
Industry UsageReviewing medical records, determining medical necessityTranslating medical reports into billing codes
Search & Comparison IntentUnderstanding clinical review roles, credential requirementsUnderstanding coding responsibilities, certification needs

Remote Physician Reviewers focus on evaluating medical records and determining medical necessity, requiring clinical credentials and medical licenses. Remote Medical Coders translate medical documentation into billing codes, requiring coding certifications. Both roles are remote healthcare positions but serve different functions within the industry.

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Remote Physician Reviewer jobs near you
Infographic showing various Remote Physician Reviewer job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 4% As Needed, 77% Full Time, 14% Part Time, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $154,712 per year, or $74.4 per hour.

Physician Reviewer (Remote)

Professional Health Care Network (PHCN)

Phoenix, AZ • Remote

Full-time

Posted 11 days ago

Job description

tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and services designed to manage the total cost of care.

We are currently looking for a Physician Reviewer to join our growing team on a full time basis!

The Physician Reviewer is in a utilization management reviewer role at tango - providing UM case reviews, peer to peer calls/conversations and consultations in real-time; assisting as a resource with functional areas such as utilization management/review, provider relations and communications, and working with physicians to provide education, peer to peer reviews and support.

Office Location:

Remote - flexible hours

Essential Functions:

  • Perform focused real-time case reviews by reviewing the information in the software system(s).
  • Applies medical judgement and pertinent evidence based clinical guidelines to determine medical necessity on pre-service, concurrent, and retroactive and claims reviews of medical home health services.
  • Reviews Potential Quality Issues (PQIs).
  • The Physician Reviewer will provide quality reviews that address the individual needs of the member, align with medical evidence guidelines, and meet compliance requirements.
  • The Physician Reviewer will identify and appropriately document areas of inappropriate utilization of resources.
  • Participates in inter-rater review cases.
  • Perform Peer-to-Peer case discussions with payer medical directors, PCP's, hospitalists and specialists.
  • The Physician Reviewer must maintain positive relationships with a variety of external and internal stakeholders, including working closely with primary care physicians, specialists, hospitalist physicians, nursing, therapists, and staff, participate in interdisciplinary team meetings.
  • Provides medical guidance and review activities for home health utilization management and medical quality improvement activities and programs in accordance with health plan, regulatory, state, corporate, and NCQA accreditation requirements.
  • Attend and participate as assigned quarterly UM, QM and Compliance Committee Meetings.
  • Provide input on clinical content for specific programs.
  • Evaluate potential quality of care concerns as assigned.
  • Assist in developing and reviewing policies as requested/needed.
  • Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice and/or return to acute (RTA's) to improve the quality and cost of care.
  • Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality for home care services.
  • Participate in all aspects of regulatory compliance related to health services functions at tango.
  • The physician Reviewer must function within the virtual environment and be able to work individually, while working collaboratively with the clinical/medical management team.

Qualifications:

  • MD or DO license in good standing and no restrictions in state where UM reviews are conducted.
  • Board certified preferable in a primary care specialty (Internal Medicine, gerontology, Family Medicine, Physical Medicine and Rehabilitation).
  • Must be an actively practicing physician with 10+ years' practice.
  • Course work in the areas of Health Administration, Health Financing and Insurance is helpful.
  • Board Certification through American Board Medical Specialties.

Knowledge and Experience:

  • 3+ years of health plan or IPA experience conducting UM Authorization and determination reviews preferred.
  • Peer-to-Peer meeting experience.
  • Medicare Advantage, Medicare and Medicaid experience.
  • Must be proficient and have good computer and technology skills.
  • CMS Chapter 7 Home Health knowledge is a plus.
  • Supports a culture of continuous quality improvement.
  • 2+ years Milliman Care Guidelines or InterQual experience.

tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.

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