Medical Review Specialist Jobs in the United States
Pyramid Consulting, Inc
$50 - $55
Foster City, CA
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Immediate need for a talented Medical Information Manager / MLR Review Specialist (Veeva, Oncology, Pharma) .
First Horizon Bank
Charlotte, NC
Headquartered in Memphis, TN, the banking subsidiary First Horizon Bank operates in 12 states across the southern U.S. The Company and its subsidiaries offer commercial, private banking, consumer, small business, wealth and trust management, retail brokerage, capital markets, fixed income, and mortgage banking services. The Review and Challenge Specialist serves as an independent, critical evaluator within the Third Party Risk Management (TPRM) function, providing objective oversight and quality assurance of third party risk assessments, due diligence processes, and ongoing monitoring activities.
Biolife Plasma Services
Colorado Springs, CO
See Biolife Plasma Services Terms & Conditions at https://www.biolifeplasma.com/us/legal/terms-and-conditions-of-use and Privacy Policy at https://www.biolifeplasma.com/legal/privacy-notice and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The actual hourly wage offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Biolife Plasma Services
Colorado Springs, CO
See Biolife Plasma Services Terms & Conditions at https://www.biolifeplasma.com/us/legal/terms-and-conditions-of-use and Privacy Policy at https://www.biolifeplasma.com/legal/privacy-notice and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The actual hourly wage offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Biolife Plasma Services
Colorado Springs, CO
See Biolife Plasma Services Terms & Conditions at https://www.biolifeplasma.com/us/legal/terms-and-conditions-of-use and Privacy Policy at https://www.biolifeplasma.com/legal/privacy-notice and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The actual hourly wage offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Biolife Plasma Services
Colorado Springs, CO
See Biolife Plasma Services Terms & Conditions at https://www.biolifeplasma.com/us/legal/terms-and-conditions-of-use and Privacy Policy at https://www.biolifeplasma.com/legal/privacy-notice and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions. The actual hourly wage offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
St. Luke's University Health Network
Allentown, PA
Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The RN DRG Downgrades Appeals Review Specialist is responsible for the retrospective clinical review and defense of inpatient DRG downgrades, clinical validation denials, and medical necessity determinations issued by governmental and commercial payers.
Sanford Health
$31 - $49.5
Fosston, MN
Gathers clinical data, prepares summary reports, and presents findings derived from data systems and ongoing monitoring activities to persons and committees for use in Medical Staff peer review processes and activities to include case review, Ongoing and Focused Professional Practice Evaluation, and evaluation of provider applications for appointment, reappointment and request for clinical privileges. Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).
UF Health
$70158.4 - $121492.8
Gainesville, FL
Motor Vehicle Operator Designation: Employees in this position: Will not operate vehicles for an assigned business purpose NOTE: A frequent driver is defined as one who uses his/her personal or Shands automobile a) at least once daily, b) at least five individual trips per week or c) drives, on average, over 150 miles per week in the performance of his/her job. Qualifications: Minimum Education and Experience Requirements: Either a graduate of an accredited Respiratory Therapy program, with current State of Florida licensure as a Registered Respiratory Therapist, or a graduate of an accredited Registered Nurse program, with a current State of Florida licensure.
Jobot
$20 - $24
Albuquerque, NM
Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. With a minimum of 5 years of experience in the healthcare industry, the Consulting Medical Billing Specialist will play a critical role in our organization, ensuring that our billing operations run smoothly and effectively.
Providence Health and Services
$65.24 - $102.99
Chugiak, AK
Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, and hospice and home care. Demonstrates a firm knowledge base and clinical expertise, function as a clinical resource, conduct and facilitate patient care consultation, and provide resources to assess the impact of appropriate practice on patient outcomes.
University of Utah
$18 - $20
Salt Lake City, UT
EQUIVALENCY STATEMENT: 1 year of higher education can be substituted for 1 year of directly related work experience (Example: bachelor's degree = 4 years of directly related work experience). The Utah Lions Eye Bank, in partnership with the John A. Moran Eye Center, seeks dedicated professionals to join our mission of restoring vision and transforming lives worldwide.
Bethesda Health
$63943 - $106407
Belleville, IL
Oversees resident care activities that increase risk of infection (i.e., use and care of urinary catheters, wound care, incontinence care, skin care, point-of-care blood testing, and medication injections). Develops and implements an ongoing infection prevention and control program to prevent, recognize, and control the onset and spread of infections in order to provide a safe, sanitary, and comfortable environment.
ChristianaCare
$100152 - $160243.2
Newark, DE
ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,450 beds), a free-standing emergency department, a Level I trauma center, a Level III neonatal intensive care unit, a comprehensive stroke center, and regional centers of excellence in heart and vascular care, cancer care, and women’s health. Exceptional Work/Life balance benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets, and much more!
A-Line Staffing Solutions LLC
$18
Atlanta, GA
This role is ideal for candidates with experience in medical records, chart review, or HEDIS-style documentation auditing —not direct patient care. If you thrive in a fast-paced, high-volume environment and have strong attention to detail, this is a great opportunity to grow your career in healthcare operations.
Atrium
$19 - $23
Lithia, FL
Our valued client, a reputable and fast-growing outpatient clinic, is seeking a Medical Collections Specialist to join their dynamic Revenue Cycle department. This Medical Collections Specialist will be joining the cohesive Revenue Cycle team, reporting directly to the Billing Manager, and will be responsible for the full cycle medical collections process.
CenterWell Senior Primary Care
$246100 - $344200
North Myrtle Beach, SC
Ensure clinicians effectively co-manage high-risk episodes of care and patients with partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization. Personally deliver high-quality primary care and demonstrate a high degree of patient care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management.
Flagstar Bank
Jackson, MI
Demonstrates a strong ability to build and maintain effective relationships with stakeholders by communicating clearly, engaging in proactive collaboration, and leveraging cross functional insights. File Review and Data AccuracyReview and correct incoming check file data to ensure accuracy and completeness prior to processing Identify and resolve discrepancies.
Flagstar Bank
$80939 - $116049
Remote, MI
The Senior Operations Specialist– Asset Based Finance serves as a senior resource within the ABL Operations team, acting as a key partner to the ABL Operations Lead in the coordination, execution, and oversight of day-to-day functions. Minimum experience required: 6+ Years in Asset-Based Lending operations, including experience with collateral monitoring, loan servicing, and system reconciliation.
UNC Health
$31.04 - $44.62
Raleigh, NC
May provide input into budgetary process by identifying capital equipment needs and anticipating laboratory or program needs. Must possess a strong working knowledge of both manual and automated hematology processes, including manual cell identification.
Methodist Health System
Richardson, TX
Your Job Responsibilities: • Communicate clearly and openly • Build relationships to promote a collaborative environment • Be accountable for your performance • Always look for ways to improve the patient experience • Take initiative for your professional growth • Be engaged and eager to build a winning teamMethodist Richardson Medical Center is a 443-bed, full-service, acute care hospital that serves Richardson, Garland, Plano, and surrounding areas in Dallas and Collin counties. We also provide services at Methodist Richardson Medical Center – Campus for Continuing Care, which include a behavioral health and addiction recovery unit, inpatient rehabilitation, long-term acute care, and more.
Carle Health
Urbana, IL
The Child Life Specialist works to meet the psychosocial needs of patients and families by providing education, preparation, procedural support, and therapeutic play to reduce stress and enable pediatric patients to cope more effectively with their medical experiences. Candidates must have the completed 10 required courses as outlined by Association of Child Life Professionals along with a completed 600-hour Child Life Specialist internship completed & listed on the submitted resume/application to be considered.
UF Health
$37752 - $50086.4
Gainesville, FL
Overview: To deliver excellent patient centered service in a medical office setting by scheduling patient appointments, collecting co-payments / pre-payments / other payments, reviewing patient balances, entering charges promptly and accurately, processing referrals, and maintaining a comfortable wait experience for patients based on practice protocols and UF Health Physicians policies and procedures. Associate Degree or equivalent course work may substitute for the one year required experience.
CarePartners
Waynesville, NC
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Located in Asheville, North Carolina, it’s services include a Rehabilitation Hospital, Home Health, Outpatient Rehabilitation, Hospice, Palliative Care, Private Duty, PACE (Program of All-inclusive Care for the Elderly) and Orthotics & Prosthetics.
Boeing
$85000 - $115000
Saint Charles, MO
The Boeing Company also provides eligible employees with an opportunity to enroll in a variety of benefit programs, generally including health insurance, flexible spending accounts, health savings accounts, retirement savings plans, life and disability insurance programs, and a number of programs that provide for both paid and unpaid time away from work. The Boeing Defense, Space & Security (BDS) Software Engineering organization is seeking a Software Configuration Management Specialist (Associate or Experienced) for the Precision Engagement Systems programs team in St.
CornerStone Staffing
$18.5 - $19.5
Irving, TX
Position Overview: The Dental Claims Resolutions Specialist supports revenue cycle operations within a dental services environment by coordinating with insurance carriers to resolve outstanding dental claims. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners.
Flagstar Bank
Hicksville, NY
This position plays a critical role in reinforcing the enterprise risk management framework by leading risk-based reviews of first line activities, validating the design and effectiveness of controls, and delivering actionable insights to strengthen governance and compliance practices. The Senior Enterprise Testing Specialist is responsible for independently planning and executing testing and monitoring activities to assess whether business units are effectively operating in accordance with applicable laws, regulations, internal policies, and control expectations.
CornerStone Staffing
Sherman, TX
This role supports optimal reimbursement and regulatory compliance by converting detailed clinical documentation into compliant ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) and ICD-10-PCS (Procedure Coding System) codes. Your expertise will directly influence MS-DRG (Medicare Severity Diagnosis Related Group) assignment, audit outcomes, and revenue cycle performance.
Geisinger
Danville, PA
Promotes a partnership with the inpatient coding professionals to ensure the accuracy of principal diagnosis, procedures and completeness of supporting documentation to determine the working and final DRG, severity of illness and risk of mortality. It is expected that the CDIS have previous clinical skills, including an understanding of Anatomy and Physiology in order to appropriately discuss with the physician such issues as the underlying etiology, principal diagnosis, diagnostic studies, treatment modalities, to name a few.
Carle Health
Peoria, IL
Participates in multidisciplinary rounds and initiates timely referrals to other internal healthcare team members (quality improvement, risk manager, social workers, pharmacy, therapy services, etc.) Performs case management activities of assessment, coordination, planning, monitoring, implementation, and evaluation. Ensures patients receive proactive initial assessment of needs, ongoing evaluations, and initiation of discharge planning while facilitating a safe and timely transition from the acute care/hospital setting to an appropriate level of care outside the hospital.
ChanceLight Behavioral Health, Therapy, & Education
$55000 - $70000
Shiloh, OH
Starting Salary: $55,000 - $70,000 /year based on experience Environment: Special Education Program, Grades K-12️ Availability: 2026 - 2027 School YearChanceLight Behavioral Health, Therapy, & Education, a growing, dynamic organization with a social mission to offer hope, is seeking an Intervention Specialist to join our award-winning team for the 2026-2027 School Year and perform meaningful work in a culture that welcomes innovation, encourages creative expression and offers limitless potential for personal and professional satisfaction! If you're passionate about empowering students with diverse learning needs, thrive in a collaborative and dynamic educational environment, and bring creativity, patience, a solution-focused mindset, a sense of humor, and an unwavering commitment to student growth — We Should Talk!
ChanceLight Behavioral Health, Therapy, & Education
$55000 - $70000
Mansfield, OH
Environment: Special Education Program, Grades K-12ChanceLight Behavioral Health, Therapy, & Educationis seeking an Intervention Specialist who values strong collaboration, small class sizes, and a benefits structure you simply don't see in most school districts to join our Special Education team in Mansfield, OH! As an Intervention Specialist, you'll lead the instructional process for students in Grades K-12 with Individualized Education Plans (IEPs), designing dynamic and personalized learning experiences within the learning center and/or classroom.
CrossLink
Claremont, NC
Position Summary: The Associate Clinical Sales Specialist is specifically responsible for obtaining and maintaining expert knowledge of Stryker Joint Replacement product portfolio including the Mako Robotic System for assigned territory and customers. As a condition of consideration for employment, selected candidates are required to successfully complete the MSC TotalOrtho+ or TotalOrtho Program, including all associated coursework, clinical training, and formal evaluations.
Medline Industries - Transportation & Operations
Mundelein, IL
This role is responsible for writing stability protocols/reports, evaluating stability data, performing risk assessment, and supporting process improvements. Determine the tests and acceptance criteria required for stability in collaboration with testing subject matter experts and product divisions.
Geisinger
Danville, PA
It is expected that the CDIS have previous clinical skills, including an understanding of Anatomy and Physiology in order to appropriately discuss with the physician such issues as the underlying etiology, principal diagnosis, diagnostic studies, treatment modalities, to name a few. The Clinical Documentation Improvement Program (CDI) is designed to improve the physician’s documentation in the patient’s medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient.
Carle Health
$34.01 - $58.5
Urbana, IL
Certifications: Accredited Case Manager (ACM) within 3 years - American Case Management Association (ACMA); Basic Life Support (BLS) within 30 days - American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education: College Diploma: Nursing, Work Experience: Responsibilities. Ensures patients receive proactive initial assessment of needs, ongoing evaluations, and initiation of discharge planning while facilitating a safe and timely transition from the acute care/hospital setting to an appropriate level of care outside the hospital.
Carle Health
Normal, IL
Certifications: Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR); Certified Case Manager within 3 years - Commission for Case Manager Certification (CCMC); Accredited Case Manager (ACM) within 3 years - American Case Management Association (ACMA), Education: Associate‘s Degree: Nursing, Work Experience: Acute care . Participates in multidisciplinary rounds and initiates timely referrals to other internal healthcare team members (quality improvement, risk manager, social workers, pharmacy, therapy services, etc.) Performs case management activities of assessment, coordination, planning, monitoring, implementation, and evaluation.
CornerStone Staffing
Dallas, TX
By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. CornerStone Staffing is seeking a detail-driven Foreclosure Specialist I to join a growing legal services and loan servicing team.
Jobot
$20 - $25
Orlando, FL
Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. The ideal candidate has a strong background in matching and batching invoices, coding to the general ledger, and data entry of vendor information in an ERP system.
CFS
$55000 - $70000
East Hartford, CT
If you are looking for an Accounting Specialist opportunity with stability, modern systems, strong profit sharing, and long-term career growth, this Accounting Specialist role offers a great path forward. Highly visible Accounting Specialist role working closely with an approachable CFO and collaborative finance team .
UF Health
Gainesville, FL
Overview: To deliver excellent patient centered service in a medical office setting by scheduling patient appointments, collecting co-payments / pre-payments / other payments, reviewing patient balances, entering charges promptly and accurately, processing referrals, and maintaining a comfortable wait experience for patients based on practice protocols and UF Health Physicians policies and procedures. Associate Degree or equivalent course work may substitute for the one year required experience.
Intermountain Health
$80000 - $96000
Grand Junction, CO
The Registered Dietitian Specialist facilitates the nutrition care process in specialty care areas or specialized populations with a moderate degree of autonomy, using experience-based knowledge, nutrition assessment, and diagnostic reasoning skills and competencies. Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
Jepsen Investments, Inc
$24
Chicago, IL
Our client a busy Medical Insurance Company, is currently looking to hire an experienced remote temporary possibly temporary to hire full-time Medicare Benefits Customer Care Specialists. Process changes to CAMS System, including personal and coverage information; send confirmation of additions, deletions, and/or any changes to coverage as needed.
NYS Office of Temporary and Disability Assistance
Albany, NY
NYS OTDA seeks to promote a diverse workforce that is a representation of the various cultures, voices, backgrounds, ideas, and talents of the citizens and communities that we serve. Substitutions: associate’s degree may substitute for two years of specialized experience; bachelor’s degree may substitute for four years of specialized experience; master’s degree may substitute for five years of specialized experience; J.D.
Vaco LLC
$65000 - $80000
Phoenix, AZ
Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
City National Bank
$25.93 - $41.43
Newark, DE
WHAT WILL YOU DO?The KYC Review (Specialist – Senior) will perform Enhance Due Diligence (EDD) reviews for commercial loan borrowers and prospect reviews utilizing a variety of internal bank systems and external research tools to investigate, research, and prepare documentation/summaries consistent with resolution of investigation. Additional Qualifications Analytical skills, solid understanding of deposit and loan transactions, use of good judgment, attention to detail, internet savvy, good knowledge of Bank Secrecy Act and USA PATRIOT acts.
Jobot
$30 - $35
Ontario, CA
Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. The Sales Support Order Fulfillment Specialist II is responsible for managing the order fulfillment process for assigned customer accounts, ensuring timely and accurate processing, shipment, and communication via email, chat and phone.
HCA HealthONE Aurora
$36.5 - $55.25
Aurora, CO
Offering services across the continuum of care to meet patients’ total healthcare needs, HCA HealthONE includes seven acute care hospitals, a dedicated flagship pediatric hospital, a rehabilitation hospital, CareNow® urgent care clinics, mental health campuses, imaging and surgery centers, physician practices, home and hospice care, and AirLife Denver, which provides regional critical care air and ground transportation. Here is some of what you can expect from being a Cardiovascular Specialist – Cath Lab Registered Nurse with us: You will assume responsibility for the routine care and maintenance of radiological equipment, in addition, assumes responsibility for quality patient care, maintenance of required cath lab competencies and assistance in all aspects of invasive, or non-invasive cardiac procedures.
USAA
$60000 - $72000
Colorado Springs, CO
Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
O'Reilly Automotive Stores
$36.65 - $40.65
Brooklyn Park, MN
Responsible for daily maintenance and repair issues of all facilities and grounds systems, including structural components, electrical work, plumbing, roofing repairs, carpentry, painting, welding, parking lot maintenance, etc. Ensure ongoing preventative maintenance for all systems operational in the DC; including HVAC systems, electrical units, lighting, roofing system, generators, parking lots, fans, restrooms and other plumbing systems, etc.