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Insurance Nurse Reviewer Jobs in Indiana (NOW HIRING)

LOGAN Community Resources, Inc.

NURSE - LPN

South Bend, IN · On-site

$26.75 - $36.25/hr

... insurance Full time employees eligible for Public Service Loan Forgiveness Program Employee ... Reviews all risk plans for effectiveness. * Teaches Core A and B for staff as assigned.

Logan Community Resources Inc

NURSE - LPN

South Bend, IN · On-site

$26.75 - $36.25/hr

... insurance Full time employees eligible for Public Service Loan Forgiveness Program Employee ... Reviews all risk plans for effectiveness. * Teaches Core A and B for staff as assigned.

Cna

Claims Quality Review Sr Consltant

Indianapolis, IN · Hybrid

$72K - $141K/yr

At CNA, we strive to create a culture in which people know they matter and are part of something ... A solid understanding of the insurance industry, its practices and operations. * Technical ...

Logan Community Resources Inc

NURSE - LPN

South Bend, IN · On-site

$25.25 - $34.25/hr

... insurance Full time employees eligible for Public Service Loan Forgiveness Program Employee ... Reviews all risk plans for effectiveness. * Teaches Core A and B for staff as assigned.

Traditions Management

Nurse

Lafayette, IN · On-site

... insurance • Dental insurance • Vision insurance • Retirement plan • Paid time off • ... For further information, please review the Know Your Rights notice from the Department of Labor.

Traditions Management

Nurse

Lafayette, IN · On-site

... insurance • Dental insurance • Vision insurance • Retirement plan • Paid time off • ... For further information, please review the Know Your Rights notice from the Department of Labor.

Traditions Management

Nurse

Sellersburg, IN · On-site

... insurance • Dental insurance • Vision insurance • Retirement plan • Paid time off • ... For further information, please review the Know Your Rights notice from the Department of Labor.

Traditions Management

Nurse

Indianapolis, IN · On-site

... insurance • Dental insurance • Vision insurance • Retirement plan • Paid time off • ... For further information, please review the Know Your Rights notice from the Department of Labor.

Traditions Management

Nurse

Westfield, IN · On-site

... insurance • Dental insurance • Vision insurance • Retirement plan • Paid time off • ... For further information, please review the Know Your Rights notice from the Department of Labor.

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Insurance Nurse Reviewer information

See Indiana salary details

$26

$35

$40

How much do insurance nurse reviewer jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for insurance nurse reviewer in Indiana is $35.24, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $39.33 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an insurance nurse reviewer?

To thrive as an Insurance Nurse Reviewer, you need a current nursing license, clinical experience, and a strong understanding of medical terminology and claims review processes. Familiarity with utilization review software, health insurance claims systems, and URAC or CM certification is often required. Attention to detail, critical thinking, and effective written and verbal communication skills help you excel in this position. These qualifications and abilities are vital for accurately evaluating medical records, ensuring compliance, and making informed decisions regarding healthcare coverage.

What does an insurance nurse reviewer do?

On a typical day, an Insurance Nurse Reviewer spends much of their time reviewing patient medical records, evaluating insurance claims for medical necessity, and documenting their findings in detail. The role often involves collaborating with physicians, case managers, and adjusters to clarify information or seek additional insights when necessary. You may also participate in team meetings to discuss complex cases, ensure adherence to regulatory standards, and stay current with evolving policies. The work is largely independent but requires strong communication skills and a systematic approach to managing multiple cases effectively.

What is an insurance nurse reviewer?

An Insurance Nurse Reviewer is a licensed nurse who evaluates medical claims to ensure they meet policy guidelines and medical necessity. They review patient records, treatment plans, and healthcare provider documentation to determine coverage eligibility. Their role helps insurance companies manage costs while ensuring patients receive appropriate care. Strong clinical knowledge and attention to detail are essential for assessing claims accurately.

What are the most commonly searched types of Insurance Nurse Reviewer jobs in Indiana? The most popular types of Insurance Nurse Reviewer jobs in Indiana are:
What are popular job titles related to Insurance Nurse Reviewer jobs in Indiana? For Insurance Nurse Reviewer jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Insurance Nurse Reviewer jobs in Indiana look for? The top searched job categories for Insurance Nurse Reviewer jobs in Indiana are:
Insurance Nurse Reviewer jobs near you
Infographic showing various Insurance Nurse Reviewer job openings in Indiana as of August 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $73,302 per year, or $35.2 per hour.

Utilization Management Representative I

Elevance Health

Indianapolis, IN • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 14 days ago

Elevance Health rating

7.7

Company rating: 7.7 out of 10

Based on 349 frontline employees who took The Breakroom Quiz

200th of 303 rated insurance

Job description

Anticipated End Date:

2026-08-21

Position Title:

Utilization Management Representative I

Job Description:

Utilization Management Representative I

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.


The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review.

Hours: Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift hours from 8:30 AM to 5:30 PM Mountain Time. Please adjust for your time zone. Candidates will be required to work rotating weekends and select holidays, and must be flexible and available to work overtime. Weekend shift hours may vary.

How you will make an impact:

  • Managing incoming calls or incoming post services claims work.

  • Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.

  • Refers cases requiring clinical review to a Nurse reviewer.

  • Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.

  • Responds to telephone and written inquiries from clients, providers and in-house departments.

  • Conducts clinical screening process.

  • Authorizes initial set of sessions to provider.

  • Checks benefits for facility based treatment.

  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

  • Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.

  • Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.

  • Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.

  • Performs other duties as assigned.

Minimum Requirements:

  • Requires HS diploma or GED and a minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Inbound call center experience strongly preferred.

  • Medical terminology training and experience in medical or insurance field strongly preferred.

  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Level:

Non-Management Non-Exempt

Workshift:

Job Family:

CUS > Care Support

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.

What Elevance Health employees say

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Benefits

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

Social media

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