Medical Necessity Review Registered Nurse Texas Institute for Surgery LL SURG - Dallas, TX 75231-5100 Description The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate ...
Medical Necessity Review Registered Nurse Texas Institute for Surgery LL SURG - Dallas, TX 75231-5100 Description The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate ...
The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review.
The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review.
The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review.
The Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review.
We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
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We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
We are seeking physicians to support asynchronous medical necessity review following a completed genetic counseling session. Services rendered under this role will support claims submitted to federal ...
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Tampa, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Tampa, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Atlanta, GA · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Atlanta, GA · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Miami, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Miami, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Tampa, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Tampa, FL · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Atlanta, GA · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Atlanta, GA · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Wilmington, DE · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Wilmington, DE · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Grand Prairie, TX · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Grand Prairie, TX · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Grand Prairie, TX · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Nurse Reviewer 1
Grand Prairie, TX · On-site
Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
Weekday Medical Necessity Reviewer information
See salary details
$11.78 - $19.84
14% of jobs
$24.28 is the 25th percentile. Wages below this are outliers.
$19.84 - $27.91
21% of jobs
The median wage is $32.08 / hr.
$27.91 - $35.97
30% of jobs
$35.97 - $44.03
9% of jobs
$46.72 is the 75th percentile. Wages above this are outliers.
$44.03 - $52.10
3% of jobs
$52.10 - $60.16
13% of jobs
$60.16 - $68.23
1% of jobs
$68.23 - $76.29
4% of jobs
$76.29 - $84.35
0% of jobs
$84.35 - $92.42
0% of jobs
$92.42 - $100.48
5% of jobs
$11
$42
$100
How much do weekday medical necessity reviewer jobs pay per hour?
As of Aug 9, 2026, the average hourly pay for weekday medical necessity reviewer in the United States is $42.06, according to ZipRecruiter salary data. Most workers in this role earn between $22.84 and $54.09 per hour, depending on experience, location, and employer.
What is the difference between Weekday Medical Necessity Reviewer vs Medical Claims Processor?
| Aspect | Weekday Medical Necessity Reviewer | Medical Claims Processor |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications, such as RN or licensed healthcare professional | Usually requires administrative or insurance processing training, with some roles needing basic healthcare knowledge |
| Work Environment | Healthcare facilities, insurance companies, or remote settings reviewing medical necessity cases | Insurance companies, healthcare offices, or remote data entry environments processing claims |
| Industry Usage | Commonly used in health insurance and managed care organizations | Widely used across insurance providers and healthcare billing departments |
While both roles involve working within the healthcare and insurance sectors, the Weekday Medical Necessity Reviewer focuses on evaluating the medical necessity of treatments, whereas the Medical Claims Processor handles the administrative processing of insurance claims. Understanding these differences helps job seekers identify the right career path based on their skills and interests.
What cities are hiring for Weekday Medical Necessity Reviewer jobs? Cities with the most Weekday Medical Necessity Reviewer job openings:
What are the most commonly searched types of Medical Necessity Reviewer jobs? The most popular types of Medical Necessity Reviewer jobs are:
What states have the most Weekday Medical Necessity Reviewer jobs? States with the most job openings for Weekday Medical Necessity Reviewer jobs include:
Other
Posted 10 days ago
Job description
Medical Necessity Review Registered Nurse
Texas Institute for Surgery LL SURG - Dallas, TX 75231-5100
DescriptionThe Medical Necessity Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review.
This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify, mitigate, and reduce denial risk. The role also collaborates closely with Case Management to align patient status, authorization, and progression of care with payer requirements.
Essential Duties and Responsibilities:
- Conduct admission and concurrent medical necessity reviews using established criteria and ensure appropriate patient status assignment.
- Manage payer authorizations, reviews, and communications to support reimbursement and regulatory compliance.
- Identify and mitigate denial risks through proactive review of medical necessity, documentation, and authorization requirements.
- Collaborate with physicians, case management, and revenue cycle teams to support accurate clinical documentation, patient progression, and denial prevention.
- Monitor census, length of stay, high-risk cases, and reimbursement barriers, escalating issues as needed.
- Maintain complete utilization review documentation and support audits, quality initiatives, and process improvement activities.
- Education & Training:
- Associate's degree in nursing required
- Bachelor's degree in nursing preferred
- Experience:
- 3+ years of acute care experience required
- Experience in utilization review and/or case management in an acute care hospital setting required
- Licensure/Certification/Registration:
- Current RN license in the state of Texas required
- BLS required
- Must possess and maintain a valid driver's license as employees may occasionally be required to operate a company vehicle. Reasonable accommodations may be provided as required by law.
- Key Skills:
- Comprehensive knowledge of CMS regulations, utilization management standards, and commercial payer requirements.
- Strong communication, collaboration, critical thinking, and analytical skills.
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by applicable law.
About Texas Institute for Surgery
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Dallas, TX, US
Year founded
2004