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Insurance Review Specialist Jobs (NOW HIRING)

Lincare

Billing Review Specialist

Largo, FL

$17.25 - $23.50/hr

Verifies insurance benefits and eligibility for patients * Communicates with patients to resolve ... Answers billing review specialist questions accordingly * Reports issues and/or concerns in a ...

MedWatch

NY · On-site

$60 - $80/hr

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review ... Notify insured, physician, facility, and TPA of all determinations. * Perform data entry and ...

New

MedWatch

Medical Review Specialist / RN

Lake Mary, FL · Remote

$61K - $68K/yr

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review ... Notify insured, physician, facility, and TPA of all determinations. * Perform data entry and ...

RECAP INC

Utilization Review Specialist

Middletown, NY

$27 - $34/hr

As a Utilization Review Specialist, you will play a vital role in ensuring that clinical services ... insurance plans. * Conduct comprehensive reviews of clinical documentation to ensure compliance ...

Coates Field Service, Inc.

$250/hr

Survey Review Specialist Full Time Waltham, MA, US 3 days ago Requisition ID: 1263 Salary Range ... insurance, paid time off, company paid holidays, and more! #J-18808-Ljbffr

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Insurance Review Specialist information

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$27K

$57.4K

$97.5K

How much do insurance review specialist jobs pay per year?

As of Sep 9, 2026, the average yearly pay for insurance review specialist in the United States is $57,372.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,500.00 and $74,000.00 per year, depending on experience, location, and employer.

What is an insurance review specialist?

An Insurance Review Specialist is a professional who evaluates insurance policies, claims, and related documents to ensure compliance with company guidelines and regulations. They often review patient or client information, verify coverage, and check for errors or inconsistencies in insurance claims. Their role is crucial in preventing fraud, reducing denials, and ensuring that both the insurer and the insured are accurately represented. Insurance Review Specialists may also communicate with policyholders, healthcare providers, and insurance companies to clarify information or resolve discrepancies.

What are the key skills and qualifications needed to thrive as an insurance review specialist?

To thrive as an Insurance Review Specialist, you need strong analytical abilities, attention to detail, and a solid understanding of insurance policies and medical terminology, often supported by relevant experience or a degree in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHRs), and industry coding systems like ICD-10 and CPT is typically required. Excellent communication, problem-solving skills, and the ability to manage time effectively are vital soft skills for this role. These skills and qualifications are essential to ensure accurate claim reviews, minimize errors, and facilitate smooth communication between providers, payers, and patients.

What are some common challenges faced by insurance review specialists, and how can they be addressed?

Insurance Review Specialists often encounter challenges such as navigating complex policy documents, staying updated on changing regulations, and managing high volumes of case reviews within tight deadlines. To handle these effectively, specialists typically rely on strong organizational skills, continuous professional development, and proactive communication with underwriters, agents, and clients. Building expertise in interpreting policy language and leveraging technology for document management can also help streamline workflows and minimize errors.

What are popular job titles related to Insurance Review Specialist jobs?

For Insurance Review Specialist jobs, the most frequently searched job titles are:

Insurance Review Specialist jobs near you
Infographic showing various Insurance Review Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $57,372 per year, or $27.6 per hour.

Clinical Review Specialist

Yakima, WA • On-site

Comprehensive Healthcare
See more jobs at Comprehensive Healthcareexternal

$22.31 - $33.47/hr

Full-time

Medical, Life, Retirement, PTO

Re-posted 15 days ago

Job description

Who is Comprehensive Healthcare?
Comprehensive Healthcare provides innovative behavioral health and integrated healthcare services to clients of all ages. We take pride in our creative and collaborative work environment and in delivering clinically excellent, trauma-informed, recovery-oriented services.
What are we looking for in a Clinical Review Specialist?
The Clinical Review Specialist verifies client insurance coverage, provides information regarding the client's treatment to payors as requested and ensures that payors authorize treatment throughout the client's placement.
Clinical Review Specialist duties may include:
  • Verifies initial insurance coverage for each client admitted to an evaluation and treatment facility. Works with BHO's or other payor sources to verify coverage of placement, if the client does not have coverage.
  • Conducts reviews of clinical records to ensure appropriate levels of care and modalities are being provided. Effectively and collaboratively works with clinical staff when challenging the course of treatment and
    therapeutic engagement necessary. Exhibits sound clinical judgment when assisting in the development of the course of treatment.
  • Provides ongoing utilization management reviews to authorizing bodies and obtains continued authorization throughout the inpatient placement.
  • Attends facility staff meetings via telephone and obtains necessary clinical information, as well as provides information regarding insurance authorization status to the treatment team.
  • Routinely monitors and tracks different authorizing bodies to identify patterns of problems and helps to develop plans for improvement.
  • Provides training and guidance to treatment teams regarding necessary documentation and language for authorizations.
  • Assists in implementing and providing training to new clinical programs in the Residential Treatment, Crisis and Evaluation and Treatment facilities.

Qualifications:
  • Bachelor's degree in social sciences or nursing or as necessary to obtain a Washington State Substance Use Disorder Professional credential.
  • Two years of experience in a clinical position in a medical or behavioral health care setting
  • Working knowledge of current practices related to levels of care and utilization management concepts.

What Comprehensive Healthcare Can Offer You
Training and Development
  • A variety of career opportunities in a wide range of settings with room for mobility and promotion
  • Regular training opportunities including support, supervision, and consultation in implementing evidence-based services and programs

Innovative Program & Services
  • A strong reputation for providing quality, evidence-based services within a collaborative multi-disciplinary team environment
  • Innovative, forward-looking leadership that seeks to thrive in an ever-changing healthcare environment
  • Joint Commission-accredited organization committed to continuous quality improvement
  • Established partnerships with major research universities and other community and healthcare providers to implement cutting-edge treatment programs and services

Excellent Benefits
  • Competitive salaries within our communities and industry
  • Healthcare coverage for employee and qualified family members
  • Generous vacation, paid holiday and sick leave policies
  • Access to Employee Assistance Program services
  • Agency-funded retirement plan with contributions equal to 5% of compensation
  • Additional retirement investment opportunities with a 50% investment match of up to 4% of compensation
  • Agency-funded life and disability insurance program
  • Financial incentives to further employee education

Comprehensive Healthcare is proud to be an equal opportunity employer. We do not discriminate based on race, sex, age, color, religion, national origin, sexual orientation, gender identity or expression, marital status, veteran status, disability status, or any other basis prohibited by federal, state, or local law. We value the diverse perspectives and strengths that our employees bring to the workplace and we encourage individuals from underrepresented groups to apply for our positions. The Human Resources department offers accommodations and assistance for the application and interview process; please contact us to make arrangements.

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