Remote Physician Reviewers
Farmington, Hartford County, Connecticut, 06032, USA
Listed on 2026-09-12
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Doctor/Physician
Healthcare Consultant, Medical Doctor, Internal Medicine Physician
Job Description
We are seeking a Physician Reviewer to support utilization management and appeals processes by reviewing medical records and denial determinations to identify opportunities for appeal. This is an excellent opportunity for recent medical school graduates, including foreign-trained medical graduates, looking to leverage their clinical knowledge in a non-clinical physician review role. They will review medical records, denial letters, and supporting clinical documentation to determine if denied claims are medically necessary and appealable.
They will draft and submit approximately 5-6 appeal letters per day using evidence-based clinical rationale. Conduct peer-to-peer reviews with insurance carriers and providers as needed (approximately 1-2 calls per week, up to one hour per call).
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.
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- Medical Degree (MD) required.
- Recent medical school graduates encouraged - Foreign-trained medical graduates welcome.
- Strong understanding of clinical documentation, medical necessity, and healthcare delivery.
- Excellent written communication and analytical skills.
- Interest in utilization management, physician advisory services, revenue cycle, or payer-provider relations.
- Connecticut medical license preferred or willingness to obtain one.
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