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Insurance Utilization Review Jobs in Austin, TX (NOW HIRING)

Ascension

Registered Nurse Utilization Review

Austin, TX · Remote

$78K - $110K/yr

... and utilization review. * Review admissions and service requests for medical necessity ... Benefits Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits ...

Ascension

RN-Utilization Review

Austin, TX · Remote

$84K/yr

Other benefits: optional legal and pet insurance, transportation savings and more How you'll make ... May prepare statistical analysis and utilization review reports as necessary. * Oversee and ...

Ascension

RN-Utilization Review

Austin, TX · Remote

$84K - $118K/yr

May prepare statistical analysis and utilization review reports as necessary. * Oversee and ... Benefits Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits ...

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How much do insurance utilization review jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for insurance utilization review in Austin, TX is $41.90, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the key skills and qualifications needed to thrive in insurance utilization review?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

How do I get into an insurance utilization review?

To become an insurance utilization review specialist, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of insurance policies and medical terminology. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or similar credentials can enhance job prospects. Relevant skills include attention to detail, analytical thinking, and familiarity with medical records and insurance software systems.

Is insurance utilization review a stressful job?

Insurance utilization review can be stressful due to the need for accuracy, attention to detail, and meeting strict deadlines. Reviewers often handle complex cases and must balance policy guidelines with patient needs, which can contribute to job pressure. However, the level of stress varies depending on workload, work environment, and individual coping skills.

What are the most commonly searched types of Insurance Utilization Review jobs in Austin, TX?

The most popular types of Insurance Utilization Review jobs in Austin, TX are:

What are popular job titles related to Insurance Utilization Review jobs in Austin, TX?

For Insurance Utilization Review jobs in Austin, TX, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Austin, TX look for?

The top searched job categories for Insurance Utilization Review jobs in Austin, TX are:

What cities near Austin, TX are hiring for Insurance Utilization Review jobs?

Cities near Austin, TX with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Austin, TX as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, and 5% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution, with an average salary of $87,153 per year, or $41.9 per hour.

Utilization Review Coordinator - PRN position

Georgetown, TX • On-site

Georgetown Behavioral Health Institute
Health Care and Social Assistance • 51 - 200 employees
Learn more about Georgetown Behavioral Health Instituteexternal

Full-time, Per diem

Medical, Dental, Vision, Retirement, PTO

Re-posted 26 days ago

Job description

Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator.

This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services. Previous experience in utilization review or case management desirable.

This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.

Requirements

Education and/or Licensure - Bachelor's degree or equivalent in nursing preferred.

Experience - 3-5 years Admitting or Financial Counseling preferred. Prefer two years clinical experience in a facility with medical terminology and in criteria for acute psychiatric inpatient care. Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable.

Additional Requirements - Must possess or obtain a valid CPR certification and certified in facility approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation required.

Benefits

Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.

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