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Remote Physician Reviewer information

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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Infographic showing various Remote Physician Reviewer job openings in Boca Raton, FL as of August 2026, with employment types broken down into 1% Locum Tenens, 3% As Needed, 77% Full Time, 16% Part Time, and 3% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.

Licensed Physician Reviewer

Miami, FL • On-site, Remote

ChenMed, LLC
Health Care and Social Assistance • 5 - 10K employees

8.4

Company rating: 8.4 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

1st of 245 rated social care providers

People enjoy working here

Good employer

Recommended by parents

Learn more about ChenMed, LLCexternal

$204K - $292K/yr

Full-time

Re-posted 21 days ago

Job description

We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this function and coordinating care for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management.ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
  • Provides Delegated UM by covering the specified territories as assigned:
    • Establish 2-3 cases a day for each market covered (up to 6 markets); ensures attendance on all health plan and local calls; calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories.
  • Advises other physician reviewers.
  • Other duties as assigned and modified by manager.
KNOWLEDGE, SKILLS AND ABILITIES:
  • Excellent analytical and deductive reasoning skills
  • Good judgement and problem-solving skills
  • Professional and effective communication skills
  • Strong organizational skills
  • Written and verbal fluency in English
  • Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

EDUCATION AND EXPERIENCE CRITERIA:
  • Graduate from accredited Medical School with a valid, unrestricted license is required
  • Completion of Internal Medicine or Family Practice residency
  • Board Certification in Infectious Disease
  • Two (2) years' experience in Hospital medicine preferred
  • At least one (1) year of utilization review experience preferred

PAY RANGE:
$204,761 - $292,515 Salary
The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
https://chenmed.makeityoursource.com/helpful-documents
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current employees, if you want to apply to our internal career site, please click HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Remote
ChenMed logo

About ChenMed

Sourced by ZipRecruiter

We're expanding healthcare equity across America. We're already in 15 states with 100+ medical centers. As a rapidly growing, physician-led organization, we have one central focus: rescue any and every senior from a healthcare system that has failed them. Our family of brands include Chen Senior Medical Center, JenCare Senior Medical Center, and Dedicated Senior Medical Center. Recently named a 2021 Best Places To Work and one of the only healthcare companies recognized in Fortune's 2020 "Change The World" list, ChenMed prides itself on creating a culture that enables career growth and promotes inclusion for all.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Miami, FL, US

Year founded

1985

Social media

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What ChenMed employees say

Pay

Benefits

Hours and flexibility

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