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Insurance Utilization Review Jobs in Seattle, WA

Evergreen Health

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review ... Medical, vision and dental insurance * On-demand virtual health care * Health Savings Account

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review ... Medical, vision and dental insurance * On-demand virtual health care * Health Savings Account

EvergreenHealth

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review ... Medical, vision and dental insurance * On-demand virtual health care * Health Savings Account

EvergreenHealth

Denial Management Specialist

Kirkland, WA · On-site

$28.83 - $46.14/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare ... Medical, vision and dental insurance * On-demand virtual health care * Health Savings Account

Dane Street

Board-Certified Orthopedist

Bellevue, WA · On-site

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Seattle, WA

Insurance Utilization Review information

See Seattle, WA salary details

$24

$48

$78

How much do insurance utilization review jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for insurance utilization review in Seattle, WA is $48.12, according to ZipRecruiter salary data. Most workers in this role earn between $38.03 and $55.24 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 popular job titles related to Insurance Utilization Review jobs in Seattle, WA?

For Insurance Utilization Review jobs in Seattle, WA, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Seattle, WA look for?

The top searched job categories for Insurance Utilization Review jobs in Seattle, WA are:

What cities near Seattle, WA are hiring for Insurance Utilization Review jobs?

Cities near Seattle, WA with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Seattle, WA as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $100,085 per year, or $48.1 per hour.

RN In person MDS Nurse at ETCS

BETHANY OF THE NORTHWEST

Everett, WA • On-site

$50 - $60/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 29 days ago

Job description

Bethany of the Northwest is a non-profit icon of the healthcare industry for nearly 100 years. Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come join our family and find out what the “Heart of Bethany” is. Bethany of the Northwest offers a generous benefit package, competitive salary and much more.

Pay Range: $50 to $60 per hour DOE

Benefits available:

  • Medical, Dental, Vision insurance
  • Life Insurance and short-term disability coverage
  • 403b and 403b matching.
  • EAP Employee assistance program
  • Employee discounts
  • Flexible spending account
  • Paid Sick leave
  • Paid time off
  • 7 Paid holidays plus one personal of your choice
  • Referral program

The RN MDS Nurse is responsible for ensuring the timely completion of accurate assessments and interdisciplinary care plans that meet Federal and State guidelines. The MDS RN identifies resident acuity, helping to determine specific care needs and communicating those needs to the care team as well as the residents’ families and responsible parties. The MDS RN coordinates with other disciplines and trains staff on the RAI process as needed. Once completed and signed the RN will transmit the completed assessments. The RN will participate in the weekly Medicare meeting, daily clinical meeting and the monthly QAPI meeting. 

As the Case Manager the RN will communicate with the insurance companies and provide requested information to obtain continued authorization for care.

  • Active RN in the state of Washington
  • Long term care/skilled nursing experience
  • Experience with MDS process and Case Mix Management
  • Knowledge of regulatory guidelines

Bethany of the Northwest is an equal opportunity employer and prohibits discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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