MedReview Inc. logo
MedReview Inc.

MedReview Inc. helps payors identify inaccurate medical claims to save millions in overpayments.

Physician Reviewer

GeneralGeneralFull TimeRemoteSeniorTeam 201-500H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

76 days ago

Salary

$230K / year

Seniority

Senior

Postgraduate Degree5 yrs expEnglish

Job Description

Physician Reviewer

MedReview Inc.

• 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.

Job 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.

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