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 ...
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 ...
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
This role involves conducting evidence-based medical necessity reviews for inpatient and outpatient services, assessing prior authorization requests, and supporting appeals and grievance processes.
Clinical Care Reviewer
North Charleston, SC · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
North Charleston, SC · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. * Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Des Moines, IA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
The main function of a Medical Reviewer is to ensure accuracy and compliance of healthcare ... Conducts clinical review of prior authorization requests for medical necessity, coding accuracy ...
The main function of a Medical Reviewer is to ensure accuracy and compliance of healthcare ... Conducts clinical review of prior authorization requests for medical necessity, coding accuracy ...
Clinical Care Reviewer
Harrisburg, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Harrisburg, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
... medical necessity, and document decisions within required timelines. The role supports both pre- and post-payment review while ensuring privacy and compliance. The position is full-time, 40 hours ...
... medical necessity, and document decisions within required timelines. The role supports both pre- and post-payment review while ensuring privacy and compliance. The position is full-time, 40 hours ...
RN Utilization Review
Bend, OR · On-site
$48.30 - $72.45/hr
Completes Observation medical necessity reviews at a minimum of every 12 hours (twice daily). Completes Medicare extended stay reviews, as appropriate. Assigns an initial working DRG & GMLOS upon ...
RN Utilization Review
Bend, OR · On-site
$48.30 - $72.45/hr
Completes Observation medical necessity reviews at a minimum of every 12 hours (twice daily). Completes Medicare extended stay reviews, as appropriate. Assigns an initial working DRG & GMLOS upon ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Clinical Care Reviewer
North Charleston, SC · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
North Charleston, SC · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Utilization Review Nurse
Philadelphia, PA · On-site
Conduct medical necessity reviews for infusion therapy services using InterQual, medical policies, and evidence-based clinical guidelines. * Review medical records, treatment plans, and clinical ...
Utilization Review Nurse
Philadelphia, PA · On-site
Conduct medical necessity reviews for infusion therapy services using InterQual, medical policies, and evidence-based clinical guidelines. * Review medical records, treatment plans, and clinical ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
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 30, 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:
Contract Physician - Medical Necessity Review (Genetic Testing)
Remote
Everlywell •Â
51 - 200 employees51 - 200 employees
Contractor
Medical
Re-posted 5 days ago
Job description
Everlywell is a digital health company pioneering the next generation of biomarker intelligence-combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into life-changing insights-seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
Over the past decade, Everlywell has delivered close to 1 billion personalized health insights, transforming care for 60 million people and powering hundreds of enterprise partners. In 2025, an estimated 1 in 94 U.S. adults received an Everlywell test, solidifying our spot as the #1 at-home testing company in the country. Fueled by AI and built for scale, we're breaking down barriers, closing care gaps, and unlocking a more connected healthcare experience that is smarter, faster, and more personalized.
PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating access to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to diagnostic testing, treatment, and professional guidance that empowers individuals to improve their health. Our suite of services enables a broad spectrum of health industry clients to provide seamless access to diagnostic testing and related care interventions. We are a 50-state physician, registered nurse, and genetic counselor network with a strong care coordination and patient support team and technology infrastructure.
Our model integrates genetic counselors, physicians, and technology to ensure clinically appropriate and compliant genetic testing services. 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 payers. As such, strict adherence to documentation standards, medical necessity criteria, and applicable state and federal regulations is required.
Responsibilities
Qualifications
Ideal Experience
Benefits
Security Notice: Everlywell never requests fees, payment, or banking information at any stage of the recruitment process. Official communications and interview invitations will only come from verified email addresses ending in @everlywell.com or @everlyhealth.com. To ensure your application is secure, always apply directly through our official careers page at https://www.everlywell.com/careers/.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
Over the past decade, Everlywell has delivered close to 1 billion personalized health insights, transforming care for 60 million people and powering hundreds of enterprise partners. In 2025, an estimated 1 in 94 U.S. adults received an Everlywell test, solidifying our spot as the #1 at-home testing company in the country. Fueled by AI and built for scale, we're breaking down barriers, closing care gaps, and unlocking a more connected healthcare experience that is smarter, faster, and more personalized.
PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating access to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to diagnostic testing, treatment, and professional guidance that empowers individuals to improve their health. Our suite of services enables a broad spectrum of health industry clients to provide seamless access to diagnostic testing and related care interventions. We are a 50-state physician, registered nurse, and genetic counselor network with a strong care coordination and patient support team and technology infrastructure.
Our model integrates genetic counselors, physicians, and technology to ensure clinically appropriate and compliant genetic testing services. 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 payers. As such, strict adherence to documentation standards, medical necessity criteria, and applicable state and federal regulations is required.
Responsibilities
- Review clinical documentation completed by a Genetic Counselor following patient history intake and pre-test counseling.
- Assess and determine medical necessity for genetic testing.
- Review and authorize testing orders & sign required supporting documents, when deemed appropriate.
- Ensure compliance with state regulations, payer requirements, and internal clinical protocols.
- Maintain HIPAA compliance and documentation standards.
Qualifications
- Active, unrestricted medical license in good standing. License in Kansas or Arkansas (along with residence in KS or AR) prioritized.
- Medicare enrollment required. Enrollment in Kansas or Arkansas Medicaid preferred, or willingness to enroll with administrative support.
- Board Certified in primary care specialty (Internal Medicine, Family Medicine, Pediatrics, or other relevant specialty).
- Ability to independently evaluate clinical documentation and render medical necessity determinations.
- Comfortable working in a fully asynchronous, technology-enabled workflow.
- Strong attention to detail and documentation accuracy.
- Telehealth or virtual care experience preferred.
Ideal Experience
- Prior experience with genetic testing
- Familiarity with payer medical necessity criteria
- Experience working with Medicaid populations
Benefits
- Fixed payment per review
- Flexible schedule
- 100% Remote
- Professional Liability Insurance
Security Notice: Everlywell never requests fees, payment, or banking information at any stage of the recruitment process. Official communications and interview invitations will only come from verified email addresses ending in @everlywell.com or @everlyhealth.com. To ensure your application is secure, always apply directly through our official careers page at https://www.everlywell.com/careers/.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
About Everlywell
Sourced by ZipRecruiter
Company size
51 - 200 Employees
Headquarters location
Austin, TX, US
Year founded
2015