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Insurance Utilization Reviewer Jobs in Huntsville, AL

NHS Management, LLC

RN Supervisor

Huntsville, AL · On-site

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Dental Insurance, Life Insurance, Vision Insurance * 401K with company match * Paid Holidays and ...

NHS Management Services

Unit Manager RN (7a-3p)

Madison, AL · On-site

$34 - $45/hr

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Dental Insurance, Life Insurance, Vision Insurance * 401K with company match * Paid Holidays and ...

NHS Management, LLC

Unit Manager RN (7a-3p)

Madison, AL · On-site

$37.50 - $49.50/hr

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Dental Insurance, Life Insurance, Vision Insurance * 401K with company match * Paid Holidays and ...

Tesla Laboratories. Inc.

Space Planner

Huntsville, AL · On-site

$90 - $130/hr

Review and interpret architectural drawings, blueprints, and floor plans. * Coordinate projects and ... Generate utilization, capacity, occupancy, and vacancy reports using the ARCHIBUS database.

Tesla Laboratories. Inc.

Space Planner

Huntsville, AL · On-site

Review and interpret architectural drawings, blueprints, and floor plans. * Coordinate projects and ... Generate utilization, capacity, occupancy, and vacancy reports using the ARCHIBUS database.

Tesla Laboratories. Inc.

Space Planner

Huntsville, AL · On-site

Review and interpret architectural drawings, blueprints, and floor plans. * Coordinate projects and ... Generate utilization, capacity, occupancy, and vacancy reports using the ARCHIBUS database.

Tesla Laboratories. Inc.

Space Planner

Huntsville, AL · On-site

Review and interpret architectural drawings, blueprints, and floor plans. * Coordinate projects and ... Generate utilization, capacity, occupancy, and vacancy reports using the ARCHIBUS database.

Centerwell

Home Health Clinical Manager

Huntsville, AL · On-site

Conduct ongoing staff education based on documentation review, utilization review findings, and ... Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered ...

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Insurance Utilization Reviewer information

See Huntsville, AL salary details

$30.5K

$37.4K

$43.4K

How much do insurance utilization reviewer jobs pay per year?

As of Aug 31, 2026, the average yearly pay for insurance utilization reviewer in Huntsville, AL is $37,435.00, according to ZipRecruiter salary data. Most workers in this role earn between $33,500.00 and $41,400.00 per year, depending on experience, location, and employer.

What is an insurance utilization reviewer?

Insurance Utilization Reviewers are professionals who evaluate healthcare services to determine if they are medically necessary and covered by insurance policies. They review patient records, treatment plans, and insurance guidelines to ensure that the care provided aligns with established criteria and standards. Their work helps control healthcare costs, prevent unnecessary treatments, and ensure patients receive appropriate care. Utilization reviewers often communicate with healthcare providers and insurance companies to support or deny coverage decisions.

What are the key skills and qualifications needed to thrive as an insurance utilization reviewer, and why are they important?

To thrive as an Insurance Utilization Reviewer, you need a solid understanding of medical terminology, healthcare regulations, and insurance processes, usually supported by a clinical background or relevant certification. Familiarity with utilization review software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is often required. Strong analytical thinking, attention to detail, and effective communication skills help reviewers assess medical necessity and coordinate with healthcare providers. These skills ensure accurate, efficient case evaluations and compliance with policies, which are crucial for optimizing patient care and managing healthcare costs.

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

One of the primary challenges Insurance Utilization Reviewers face is balancing the need to adhere to strict insurance guidelines while advocating for appropriate patient care. Reviewers often handle high caseloads and must make timely decisions based on complex medical records, which requires strong attention to detail and up-to-date knowledge of coverage policies. Effective communication with healthcare providers and insurance representatives is also crucial to resolve discrepancies and ensure approvals. Staying organized, continuously updating clinical knowledge, and leveraging support from the utilization review team can help manage these challenges successfully.

What is the difference between Insurance Utilization Reviewer vs Insurance Claims Processor?

AspectInsurance Utilization ReviewerInsurance Claims Processor
Primary RoleReview medical necessity and appropriateness of services for insurance coverageProcess and review insurance claims for payment and accuracy
Required CredentialsOften requires healthcare or insurance certifications, such as RHIT or CPCTypically requires claims processing or insurance certifications, like CPC or CPC-H
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, healthcare providers, or claims processing centers
Industry UsageCommonly employed in health insurance and managed careWidely used across health, auto, and property insurance sectors

The main difference is that Insurance Utilization Reviewers focus on evaluating the medical necessity of services, while Insurance Claims Processors handle the administrative processing of claims. Both roles require insurance-related certifications and are integral to the insurance industry, but they serve distinct functions in the claims and coverage review process.

What are popular job titles related to Insurance Utilization Reviewer jobs in Huntsville, AL?

For Insurance Utilization Reviewer jobs in Huntsville, AL, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Reviewer jobs in Huntsville, AL look for?

The top searched job categories for Insurance Utilization Reviewer jobs in Huntsville, AL are:

Insurance Utilization Reviewer jobs near you

Therapist

Owens Cross Roads, AL • On-site

Sequel Employment Center
See more jobs at Sequel Employment Centerexternal

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 24 days ago

Job description

We are passionate about what we do and delight in providing excellent programs that make permanent, positive changes in the lives of those we serve. Our programs are designed to equip our clients with the vision, motivation, life skills, education, and self-discipline necessary to lead a successful life.
Do you want to make a difference in the lives of our youth?
Do you want a supportive work environment?
Do you want to be part of leading a youth and young adults to personal victory
and success?
If you answered "yes" then Sequel Youth and
Family Services may have the perfect job for you!!!!
Program Overview Sequel Youth and Family Services of Owens Cross Roads, is an intensive residential treatment facility providing an array of gender specific, evidenced based and trauma informed services for female adolescents, ages 12-18, with serious and/or chronic emotional and/or
behavioral management problems that interfere with the child's ability to function in the family, school and/or community setting outside of a residential environment.
Position Overview
The Master Level Therapist coordinates and delivers various programmatic treatment interventions to youth based upon their strengths and needs identified in a treatment plan.
Interventions include individual, group, and family counseling. The Master Level
Therapist acts as a liaison with sponsoring agencies, including utilization
review, progress review, and discharge planning. The Master Level Therapist
also prepares accurate documentation of services delivered within set time
frames dictated by licensing agencies and state and federal guidelines.
Job Duties
  • Interviews families and students to acquire historical
    information to be used in developing case assessments.
  • Plans and executes Family Day Schedule.
  • Conducts group, individual, and family counseling
    sessions, using professionally prescribed teaching methods, techniques and
    documenting all services delivered meeting Medicaid and Contract
    requirements.
  • Provides utilization review reports to referral source
    and sponsoring agencies.
  • Initiates family contact using professionally
    prescribed methods and techniques to convey and receive information
    regarding students during and after enrollment.
  • Interacts with students in a professional manner to
    elicit positive change.
  • Completes other reports, assessments, reviews as
    assigned in a thoroughly and timely manner meeting all set deadlines by
    contract requirements and Medicaid standards.

Job Requirements
  • Master's Degree from an accredited program in social
    work, counseling, or related discipline.
  • 1 year experience working with adolescents to
    include family and group work or equivalent combination of education and
    experience.

Benefits
  • Competitive Compensation
  • Medical, dental, vision, and life insurance after 60
    days
  • Company provided Short Term and Long Term Disability
  • Company provided AD&D insurance
  • Flexible Spending Program
  • 401K after sixty days
  • 6 paid holidays
  • 18 days personal leave accrual within first year
Sequel Youth & Family Services is an Equal Opportunity and Veteran Friendly employer.

Apply