Remote Medical Reviewer Jobs in North America
Find remote medical reviewer jobs in North America. Browse flexible work-from-home medical reviewer positions from companies hiring in North America. Start your remote career today.
Medical Review Specialist
Medical Review Specialist reviewing medical bills, coding, and treatment necessity for Michigan workers’ compensation claims. Supporting insurers, adjusters, providers, and claimants through accurate reimbursement recommendations.
Clinical Reviewer
Clinical Reviewer evaluating Illinois Medicaid behavioral-health assessments for Maximus. Reviewing PASRR determinations, quality control, documentation, and service approvals remotely.
Utilization Management Clinical Reviewer
Utilization Management Clinical Reviewer managing high-acuity inpatient cases for Evernorth Health Services. Assessing medical necessity, coordinating safe transitions, and advocating for California members.
Medical Reviewer – Laboratory Specialist
Medical Reviewer evaluating laboratory claims, authorizations, and documentation for Gainwell Technologies’ California healthcare programs. Applying laboratory expertise to support accurate medical necessity and coverage determinations.
Medical Reviewer, Laboratory Specialist
Medical laboratory reviewer supporting Gainwell’s California healthcare programs. Reviewing claims, authorizations, and documentation for coverage, medical necessity, and compliance.
Medical Reviewer – Durable Medical Equipment Specialist
Medical Reviewer evaluating DME claims, authorizations, and documentation for Gainwell’s California healthcare programs. Ensuring medical necessity, coverage, billing, and program compliance.
Medical Reviewer – Speech and Audiology Specialist
Medical Reviewer applying speech, language, and audiology expertise to California healthcare claims and authorizations. Supporting medical necessity decisions for Gainwell Technologies’ healthcare programs.
Medical Reviewer, Radiologist
Radiologist reviewing California radiology claims, medical records, and authorization requests for Gainwell Technologies. Supporting medical necessity determinations for healthcare programs.
Medical Reviewer – Prosthetic and Orthotic Devices Specialist
Medical Reviewer evaluating prosthetic and orthotic device claims for Gainwell’s California healthcare programs. Reviewing medical necessity, coverage, authorizations, and supporting documentation.
Medical Reviewer, Podiatrist
Podiatrist reviewing medical records, claims, and treatment authorizations for Gainwell Technologies’ California healthcare programs. Applying clinical judgment to medical necessity and coverage decisions.
Medical Reviewer, Registered Nurse
Medical Reviewer (Registered Nurse) reviewing California healthcare records, claims, and authorizations for Gainwell Technologies. Determining medical necessity and supporting healthcare program compliance remotely.
Medical Reviewer – Physical Therapist
Medical Reviewer evaluating physical therapy records, claims, and authorizations for Gainwell Technologies’ California healthcare programs. Supporting clinical necessity and coverage determinations remotely.
Medical Reviewer, Optometrist
Medical Reviewer applying optometric expertise to California healthcare claims, records, and authorizations. Supporting medical necessity determinations for Gainwell Technologies’ healthcare programs.
Medical Reviewer, Pharmacist
Medical Reviewer (Pharmacist) supporting Gainwell Technologies’ California healthcare programs. Reviewing pharmacy claims, drug authorizations, utilization, rebates, and clinical documentation remotely.
Medical Reviewer, Physician
Physician reviewing claims, authorizations, appeals, and clinical documentation for Gainwell’s California healthcare programs. Applying medical policy and clinical expertise to support accurate determinations.
Medical Reviewer – Medicare, Home Health
Registered Nurse reviewing complex Medicare home-health claims, authorizations, appeals, and fraud referrals. Applying clinical guidelines to determine medical necessity and support accurate payment decisions.
Clinical Reviewer – PT, OT Licensed
Clinical Reviewer evaluating workers’ compensation therapy authorizations for nonprofit Comagine Health. Applying clinical criteria, documenting medical necessity decisions, and preparing reports and denial recommendations.
Medical Clinical Reviewer, Clinical Program Specialist – Managing Consultant
Clinical reviewer supporting Guidehouse’s federal healthcare programs. Evaluating medical necessity, documentation, care pathways, and operational decisions across complex healthcare environments.
Pediatric Rheumatology – Independent Medical Reviewer
Board-certified pediatric rheumatology physician conducting objective chart reviews for MMRO, a URAC-accredited medical review organization. Producing evidence-based determinations that support healthcare decisions.
Pediatric Nephrologist – Independent Medical Reviewer
Board-certified pediatric nephrologist conducting objective, evidence-based medical chart reviews for MMRO. Producing clear determinations remotely as an independent contracted physician reviewer.