2,423 clinical reviewer jobs at 911 companies in United States
4d
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Clinical Reviewer-SCA
United States
$69k-$87k/yr RemoteFull Time
2+ YOEActive unrestricted LPN or RN license, 2+ years of clinical, call center, and clinical assessment experience, 1 year of medical record abstracting and utilization review or prior authorization experience, and Microsoft Office proficiency.
Microsoft Office, HIPAA, NCQA
1mo
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Clinical Reviewer (RN)
Jericho, New York, United States
$38-$43/hr OnsiteFull Time
1+ YOEActive New York RN license, bachelor’s in nursing or approved RN program graduate, 1–2+ years clinical or utilization review experience, EMR proficiency, strong written/verbal and problem-solving skills, able to work independently.
Electronic Medical Records (EMR)
4d
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Clinical Reviewer - Eugene, Oregon
Oregon, United States
$75k-$90k/yr RemoteFull Time
3+ YOEActive unrestricted clinical licensure, 3 years of direct patient care experience, Oregon residency, personal transportation, driver's license, auto insurance, clinical documentation review, and MS Office proficiency.
Electronic Medical Record (EMR), InterQual, Microsoft Office Suite
4d
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Initial Clinical Reviewer
United States
$59k-$73k/yr RemoteFull Time
2+ YOEDoctor of Chiropractic with a valid state license and 2+ years of clinical experience, or an advanced degree without experience. Requires clinical judgment, medical terminology knowledge, communication, and organizational skills.
software, tools
1mo
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Clinical Quality Reviewer
Chicago, Illinois, United States
$41-$48/hr OnsitePart Time
Licensed LPHA in Illinois; experience reviewing clinical documentation and IM+CANS assessments; strong coaching and written communication skills; reside in Chicago area; part-time availability (15–25 hrs/week).
IM+CANS
2w
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Clinical Reviewer - Medical Coder & QA
United States
OnsiteFull Time
2+ YOEReview and approve home health and hospice clinical documentation, complete ICD-10 coding, process OASIS/485 packets, and ensure regulatory compliance; 2 years related experience and relevant certifications required.
Windows, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Internet, OASIS
1d
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Senior Surgical Clinical Reviewer
Chicago, Illinois, United States
$101k-$118k/yr RemoteFull Time
3+ YOEBachelor’s degree and 3+ years as a Surgical Clinical Reviewer required; ACS NSQIP training and certification required. Requires quality improvement, data analysis, database, communication, and MS Office skills.
Microsoft Office, ACS NSQIP, database
2mo
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Clinical Quality Reviewer - BCBA
San Francisco, California, United States
$110k-$140k/yr HybridFull Time
2+ YOECurrent BCBA in good standing, 2+ years ABA utilization/quality experience, experience reviewing ABA treatment plans and clinical documentation, auditing skills, strong written and analytical abilities.
EHR
1w
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Clinical Transcript Reviewer
United States
$3/hr RemoteContract
Active unrestricted US clinical license, clinical judgment and risk assessment experience, excellent written communication, attention to detail, and ability to work independently on a remote flexible schedule.
3w
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ABA Clinical Reviewer
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$79k-$93k/yr RemoteFull Time
3+ YOEBCBA required, U.S. citizenship and favorable DoD background investigation, 3+ years direct clinical care, EMR experience, knowledge of InterQual and clinical coding (ICD-10-CM, DSM, CPT).
InterQual, Electronic Medical Records (EMR), Microsoft Word, Microsoft Outlook, TriWest Intranet, ICD-10-CM, DSM, CPT
2mo
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Clinical Nurse Reviewer
St. Petersburg or Plano or Boston or St. Louis or Atlanta or Morristown or Hyderabad
$59k-$75k/yr HybridFull Time
3+ YOE3+ years clinical or healthcare experience or a BA; familiarity with health insurance/Medicare guidelines, EHR systems, Microsoft Office, AI tools, strong attention to detail and ability to perform sustained computer-based work.
AI tools, EHR systems, Microsoft Office
2mo
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Clinical Safety Reviewer
New York, New York, United States
$70k-$78k/yr HybridFull Time
2+ YOEMD/DO preferred (BS/BSN/RN with experience may be considered), 2+ years safety experience preferred, proficiency with Microsoft Outlook/Word/Excel, strong communication, writing, triage and clinical analysis skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel
1w
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Physician Clinical Reviewer -Psychiatry- REMOTE
United States
$91-$154/hr RemotePart Time
1+ YOERequires MD, DO, or MBBS with U.S. training, unrestricted U.S. medical license, ABMS, ABOS, ABIM, or ABOIM board certification, and 1 year of clinical review experience.
URAC, NCQA
5d
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Medical Clinical Reviewer / Clinical Program Specialist | Managing Consultant
McLean or Tysons Corner
OnsiteFull Time
5+ YOEActive clinical license or equivalent credential; 5+ years in clinical practice, utilization management, medical review, documentation, case management, payment integrity, or healthcare operations.
AI, Medicare, Medicaid, TRICARE, VA
2mo
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Initial Clinical Reviewer - Remote - AZ
Phoenix or Tucson or Chandler or Flagstaff or Arizona
RemoteFull Time
2+ YOERequires 2 years clinical or health insurance experience, Associate's degree or nursing diploma/LPN certification, active unrestricted AZ behavioral health license OR RN (AZ or NLC) OR LPN license, PC proficiency and strong clinical knowledge.
McKesson InterQual, CPT-4, ICD-9
2w
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Insurance Reviewer-Clinical
Wichita, Kansas, United States
OnsiteFull Time
3+ YOEMinimum three years medical insurance verification and authorization experience; high school diploma required, associate degree in healthcare or business preferred; must review clinical records and obtain prior authorizations.
EMR, PMS
1mo
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Medicare Clinical Appeals Reviewer III
United States
RemoteFull Time
2+ YOEActive clinical license (RN, PT, RT, OT),2+ years medical review or appeals experience,ability to write determinations,proficiency with Microsoft 365/Excel/Word,and ability to pass background,verification, and drug screening.
Microsoft 365, Microsoft Excel, Microsoft Word
1mo
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Clinical Study Data Reviewer
Rochester, New York, United States
$60k-$74k/yr RemoteFull Time
1+ YOE1–3 years clinical data review or data management experience; bachelor’s in life science preferred; knowledge of GCP/ICH, EMR/EDC and relational databases; proficiency with Microsoft Word and Excel; strong communication and analytical skills.
Microsoft Windows, Microsoft Word, Microsoft Excel, Electronic Data Capture (EDC), relational database management software
3w
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Remote Clinical Validation Reviewer (RN)
Long Beach, California, United States
$26-$57/hr RemoteFull Time
2+ YOEActive unrestricted RN license, 2+ years inpatient payment integrity claim review including DRG validation, expertise with ICD-10/MS-DRG/AP-DRG/APR-DRG/CPT/HCPCS, clinical decision tools, and Microsoft Office.
ICD-10, MS-DRG, AP-DRG, APR-DRG, CPT, HCPCS, UpToDate, Merck Manual, Microsoft Office
1mo
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Minors Independent Clinical Reviewer / Hearing Offic
Colton, California, United States
OnsiteContract
3+ YOEMD or DO required with active California clinical license, 3+ years in child and adolescent psychiatry, expertise in psychiatric assessment, knowledge of WIC statutory review, and strong clinical documentation skills.
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