Medical Reviewer, Radiologist

Gainwell Technologies

Radiologist reviewing California radiology claims, medical records, and authorization requests for Gainwell Technologies. Supporting medical necessity determinations for healthcare programs.

Posted 8/22/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $150,000 - $175,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in evaluating radiology-related claims and medical records while providing clinical review and support for medical necessity determinations. Maintains compliance with California medical policies and regulatory guidelines, ensuring high standards of accuracy and productivity.

Highest-signal resume keywords

Radiology Clinical ReviewMedical Necessity DeterminationCalifornia Physician LicenseClinical JudgmentCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Radiology Services EvaluationMedical Record InterpretationClinical Documentation ReviewTreatment Authorization Requests (TARs)Regulatory Compliance

Soft Skills

Oral CommunicationWritten CommunicationCollaboration

Tools & Technologies

Computer Systems NavigationClinical Applications

Certifications & Qualifications

Active Physician LicenseProfessional Credentials

Industry Keywords

Medical PoliciesCoverage RequirementsQuality StandardsHealthcare Programs

About the role

Key responsibilities & impact

Review radiology-related claims, Treatment Authorization Requests (TARs), medical records, and supporting clinical documentation
Evaluate imaging and radiology services based on applicable medical policies, coverage requirements, and clinical standards
Provide physician-level medical review and clinical expertise for complex radiology cases
Support medical necessity and appropriateness determinations for requested or billed radiology services
Document review findings, decisions, and supporting clinical rationale clearly and accurately
Refer or collaborate on cases requiring additional clinical expertise when appropriate
Collaborate with physicians, nurses, other clinical specialists, operations teams, and business partners
Maintain knowledge of applicable radiology standards, medical policies, coverage requirements, and regulatory guidelines
Meet established quality, accuracy, productivity, and turnaround-time expectations
Work primarily from a home office supporting Medical Review Services for California healthcare programs
Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations

Requirements

What you’ll need

Minimum of three (3) years of experience as a Radiologist in a private, academic, or government setting
Current, non-expired physician license from the State of California, in good standing
Must not be under suspension from Medicare, Medicaid, or practice in California
Must not have been previously sanctioned for fraud or abuse
Strong oral and written communication skills
Strong clinical judgment and ability to interpret complex radiology-related medical records and supporting documentation
Maintain all professional licenses, certifications, and credentials required for the position in active, unrestricted, and good-standing status

Benefits

Comp & perks

Flexible hours
Work-life balance
Continuous learning and career development
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies
Ongoing training and support