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Reviewer Jobs in Berkeley, CA (NOW HIRING)

Onos

Clinical Quality Reviewer - BCBA

San Francisco, CA · On-site

$110K - $140K/yr

Clinical Quality Reviewer - BCBA About Onos Health Onos Health's mission is simple but ambitious: ensure every healthcare dollar goes toward delivering the highest quality care. Today, nearly 30% of ...

Penumbra

DHR Reviewer I - Temp

Alameda, CA · On-site

$22 - $32/hr

The DHR Reviewer you will play a pivotal role in maintaining the integrity of our Quality systems and processes. You will be responsible for timely and accurate support of quality processes related ...

Penumbra

DHR Reviewer I - Temp

Alameda, CA · On-site

$22 - $32/hr

The DHR Reviewer you will play a pivotal role in maintaining the integrity of our Quality systems and processes. You will be responsible for timely and accurate support of quality processes related ...

Penumbra

DHR Reviewer I - Temp

Alameda, CA · On-site

$22 - $32/hr

The DHR Reviewer you will play a pivotal role in maintaining the integrity of our Quality systems and processes. You will be responsible for timely and accurate support of quality processes related ...

Penumbra

DHR Reviewer I - Temp

Alameda, CA · On-site

$22 - $32/hr

The DHR Reviewer you will play a pivotal role in maintaining the integrity of our Quality systems and processes. You will be responsible for timely and accurate support of quality processes related ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all ...

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All JobsReviewer JobsReviewer Jobs in Berkeley, CA

Reviewer information

See Berkeley, CA salary details

$12

$36

$59

How much do reviewer jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for reviewer in Berkeley, CA is $36.59, according to ZipRecruiter salary data. Most workers in this role earn between $27.64 and $44.76 per hour, depending on experience, location, and employer.

What is a reviewer?

Reviewers are individuals who evaluate and provide feedback on various works, such as academic papers, products, services, or creative projects. Their main role is to assess the quality, accuracy, and relevance of the material, offering constructive criticism and recommendations for improvement. Reviewers are essential in maintaining standards and ensuring that only high-quality works are published or made available to the public. The specific responsibilities of a reviewer can vary depending on the industry or context in which they work.

What are the key skills and qualifications needed to thrive as a reviewer, and why are they important?

A successful Reviewer needs strong analytical thinking, attention to detail, and expertise in the relevant subject area, often supported by a degree or professional background. Familiarity with review management software, submission tracking systems, and industry-specific guidelines is commonly required. Excellent written communication, objectivity, and time management set outstanding reviewers apart. These skills ensure thorough, fair, and timely evaluations, which uphold the quality and credibility of published work or products.

How do reviewers typically collaborate with other team members during the evaluation process?

Reviewers often work closely with subject matter experts, editors, or project managers to ensure that evaluations are thorough and consistent. Collaboration usually involves regular meetings to discuss criteria, clarify expectations, and address any ambiguities in the material under review. Additionally, Reviewers may provide feedback or suggestions for improvement and participate in group discussions to achieve consensus on final recommendations. This teamwork helps maintain high standards and ensures the integrity of the review process.

What is the difference between Reviewer vs Quality Control Inspector?

AspectReviewerQuality Control Inspector
CredentialsTypically requires a degree or certification in the relevant fieldOften requires technical training or certification in inspection methods
Work EnvironmentOffice or remote review settings, analyzing documents or dataManufacturing, construction, or production sites inspecting products
Employer & IndustryPublishing, media, manufacturing, or software companiesManufacturing, construction, aerospace, or automotive industries
Search & Comparison IntentUnderstanding review roles, responsibilities, and qualificationsComparing inspection and quality assurance roles in industry

While both reviewers and quality control inspectors ensure standards are met, reviewers primarily evaluate documents, data, or content in office settings, focusing on accuracy and compliance. Quality control inspectors physically examine products or processes on-site to identify defects or issues. Their roles overlap in quality assurance but differ in work environment and specific tasks.

How to get a job as a reviewer?

To become a reviewer, gain relevant knowledge in the field you want to review, develop strong communication and critical thinking skills, and build a portfolio or sample reviews. Many reviewer roles require attention to detail, familiarity with review platforms or tools, and sometimes specific certifications or experience in the industry. Applying through company websites, freelance platforms, or industry networks can help you find opportunities.

What are the most commonly searched types of Reviewer jobs in Berkeley, CA?

The most popular types of Reviewer jobs in Berkeley, CA are:

What are popular job titles related to Reviewer jobs in Berkeley, CA?

For Reviewer jobs in Berkeley, CA, the most frequently searched job titles are:

What cities near Berkeley, CA are hiring for Reviewer jobs?

Cities near Berkeley, CA with the most Reviewer job openings:

Reviewer jobs near you
Infographic showing various Reviewer job openings in Berkeley, CA as of August 2026, with employment types broken down into 75% Full Time, 21% Part Time, and 4% Contract. Highlights an 53% Physical, 3% Hybrid, and 44% Remote job distribution, with an average salary of $76,110 per year, or $36.6 per hour.

MSO PHYSICIAN REVIEWER

North East Medical Services

Burlingame, CA • On-site

$285K - $332K/yr

Other

Re-posted 23 days ago

Job description

The MSO Physician Reviewer is responsible for ensuring the appropriate utilization of healthcare services while maintaining high standards of patient care. This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes. The Physician Reviewer collaborates with healthcare providers, UM team members, and case managers to facilitate efficient and effective care delivery.
In addition to utilization management, this role contributes case management, quality improvement initiatives, and risk adjustment analysis by identifying trends in healthcare utilization, evaluating provider documentation, and ensuring compliance with federal, state, and organizational policies. The Physician Reviewer provides clinical leadership in optimizing care pathways, reducing unnecessary hospitalizations, and enhancing patient safety.
This position requires a deep understanding of medical policies, healthcare regulations, and payer guidelines, including Medicare and Medicaid benefit coverage criteria. The ideal candidate will have strong analytical skills, excellent communication abilities, and a commitment to ensuring equitable, high-quality care. Work is varied, highly complex, and requires a high degree of discretion and independent judgment.
ESSENTIAL JOB FUNCTIONS:
  • Evaluate medical necessity, appropriateness, and efficiency of healthcare services using evidence-based criteria (e.g., MCG, CMS, and NCQA guidelines).
  • Review and assess prior authorization requests for procedures, hospital admissions, specialty referrals, and medications.
  • Provide peer-to-peer consultations with treating physicians to discuss medical necessity determinations and alternative treatment options.
  • Participate in the appeals and grievance process by reviewing denied claims and reconsidering medical necessity based on additional documentation.
  • Conduct retrospective and concurrent reviews of medical records to ensure accurate risk stratification and appropriate coding and documentation based on patient complexity.
  • Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models.
  • Support provider education on proper documentation and coding practices to reflect complete and accurate disease burden and clinical acuity.
  • Participate in chart reviews and audits to ensure compliance with risk adjustment methodologies and HCC coding.
  • Evaluate coding trends and audit results to identify undercoded or miscoded diagnoses that may impact risk scores and compliance.
  • Work collaboratively with case managers, social workers, and care teams to optimize patient care and resource utilization.
  • Support efforts to reduce readmissions and enhance patient outcomes through evidence-based interventions.
  • Participate in quality improvement initiatives, such as identifying trends in over- or underutilization, gaps in care, or process inefficiencies.
  • Collaborate with clinical and operational leadership to develop protocols and guidelines that enhance patient safety and care quality.
  • Review and analyze clinical data to support performance improvement projects and accreditation requirements.
  • Performs other job duties as required by manager/supervisor.

  • Medical Degree (MD or DO) from an accredited institution.
  • Board Certification in a relevant specialty (Internal Medicine, Family Medicine, Emergency Medicine, or another applicable field).
  • Active and unrestricted medical license in California.
  • Minimum of 3-5 years of clinical experience; prior experience in utilization management, case review, HCC, risk adjustment, or managed care is preferred.
  • Knowledge of medical necessity criteria, healthcare regulations, and payer policies (Medicare, Medicaid, and/or commercial insurance).
  • Familiarity with UM guidelines (MCG, InterQual, CMS, NCQA, URAC) and utilization review process.
  • Experience conducting peer-to-peer reviews and provider education sessions.
  • Strong understanding of risk adjustment methodologies (e.g. HCC coding and RAF scoring) preferred.
  • Knowledge of value-based care models, population health management, and healthcare cost containment strategies.
  • Supervisory experience in a healthcare setting a plus.

LANGUAGE:
  • Must be able to fluently speak, read and write English.
  • Fluent in Chinese (Cantonese and/or Mandarin) preferred
  • Fluency in other languages are an asset.

STATUS:
  • This is an FLSA exempt position.
  • This is not an OSHA high-risk position.
  • This is a Full Time position.

NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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