Physician Reviewer

MedReview Inc.

DRG Clinical Physician Reviewer at MedReview focusing on clinical validation and quality assurance. Remote position with responsibilities in supporting healthcare quality and reimbursement integrity.

Posted 6/25/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $230,000 per yearWebsite

About the role

Key responsibilities & impact

Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant
Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines
Produce clear, concise clinical summaries and determinations within established turnaround times
Identify opportunities for improved documentation, coding accuracy, and cost containment
Conduct readmission and level of care reviews, including outlier and appeal cases
Collaborate with internal teams and, when needed, engage with providers to support clinical findings
Contribute to quality assurance initiatives and ongoing program development.

Requirements

What you’ll need

MD/DO required with active, unrestricted U.S License
Board Certification required (ABMS or AOA)
5+ years of clinical practice experience
Strong utilization review experience (UM, DRG Validation, or clinical documentation review)
Experience with DRG Validation, CDI, or claims review strongly preferred
Proven ability to interpret complex clinical data and apply guidelines objectively
Strong written communication skills with the ability to clearly justify clinical decisions.

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account MedReview Inc. Website LinkedIn All Job Openings 201 - 500 employees ⚕️ Healthcare Insurance 💸 Finance Healthcare Insurance
Finance MedReview Inc. is a leading provider of advanced payment integrity solutions, specializing in healthcare claims. They work with a wide range of clients, including health plans, government agencies, and payors, to reduce unnecessary waste and save billions of dollars. Their team of highly trained physicians, registered nurses, and certified coders conduct thorough clinical and coding reviews to identify inaccuracies in healthcare claims. MedReview employs proprietary algorithms to analyze complex data and detect suspicious payment trends, offering a unique blend of clinical expertise and advanced technology to maximize efficiencies and improve healthcare cost management. Physician Reviewer 🔥 1 minute ago 🇺🇸 United States – Remote 💵 $230k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant
Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines
Produce clear, concise clinical summaries and determinations within established turnaround times
Identify opportunities for improved documentation, coding accuracy, and cost containment
Conduct readmission and level of care reviews, including outlier and appeal cases
Collaborate with internal teams and, when needed, engage with providers to support clinical findings
Contribute to quality assurance initiatives and ongoing program development. 🎯 Requirements
MD/DO required with active, unrestricted U.S License
Board Certification required (ABMS or AOA)
5+ years of clinical practice experience
Strong utilization review experience (UM, DRG Validation, or clinical documentation review)
Experience with DRG Validation, CDI, or claims review strongly preferred
Proven ability to interpret complex clinical data and apply guidelines objectively
Strong written communication skills with the ability to clearly justify clinical decisions. Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Enrollment Advisor 🔥 2 minutes ago Keypath Education 501 - 1000 📚 Education ☁️ SaaS ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Enrollment Advisor facilitating prospective students through their university application process. Supporting students from lead to start to ensure informed decisions and timely admissions. 🇺🇸 United States – Remote 💵 $65k - $75k / year ⏰ Full Time 🟢 Junior 🟡 Mid-level Member Experience Specialist 🔥 2 minutes ago Chevron Federal Credit Union 201 - 500 🏦 Banking 💸 Finance 🤝 Non-profit Website LinkedIn All Job Openings Member Experience Specialist delivering excellent member experiences at Chevron Federal Credit Union. Engaging with members, processing transactions, and promoting products and services. 🇺🇸 United States – Remote 💵 $20 - $27 / hour ⏰ Full Time 🟢 Junior 🟡 Mid-level 🚫👨‍🎓 No degree required Senior Mortgage Processor 🔥 2 minutes ago Chevron Federal Credit Union 201 - 500 🏦 Banking 💸 Finance 🤝 Non-profit Website LinkedIn All Job Openings Mortgage Processor assisting with real estate loan processing at Chevron Federal Credit Union. Responsible for managing loan documentation, workflow, and pipelines. 🇺🇸 United States – Remote 💵 $33.3k - $68.3k / year ⏰ Full Time 🟠 Senior COWS Program Specialist – Western US 🔥 3 minutes ago Novus International 1 - 10 🏠 Real Estate 🤝 B2B 💸 Finance Website LinkedIn All Job Openings Program Specialist responsible for data analysis and field implementation of the Novus C.O.W.S. program in the Western US. Focused on sales support and industry engagement for animal nutrition. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior COWS Program Specialist – Central and Midwest US 🔥 3 minutes ago Novus International 1 - 10 🏠 Real Estate 🤝 B2B 💸 Finance Website LinkedIn All Job Openings Implementing the Novus C.O.W.S. program in US and Canada, providing technical assistance and building relationships across the ruminant market. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical validationmedical record evaluationevidence-based guidelinesdocumentation improvementcoding accuracyutilization reviewDRG validationclinical documentation reviewclaims reviewclinical data interpretation

Soft Skills

written communicationcollaborationquality assuranceprogram developmentclinical decision justification

Certifications

MDDOactive U.S. LicenseBoard CertificationABMSAOA