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Insurance Utilization Reviewer Jobs in Muscatine, IA

ICBD

BCBA Relocate to Puerto Rico

Iowa City, IA · On-site

$85K/yr

Medical, dental, vision, long-term disability, life insurance, AD&D insurance, and GAP Plan ... (QA), Utilization Review (UR), Assessments, Training & Development, and Research. Whether your ...

ICBD

BCBA Relocate to Puerto Rico

Iowa City, IA

$85K/yr

Medical, dental, vision, long-term disability, life insurance, AD&D insurance, and GAP Plan ... (QA), Utilization Review (UR), Assessments, Training & Development, and Research. Whether your ...

ICBD

BCBA Relocate to Puerto Rico

Iowa City, IA · On-site

$85K/yr

Medical, dental, vision, long-term disability, life insurance, AD&D insurance, and GAP Plan ... (QA), Utilization Review (UR), Assessments, Training & Development, and Research. Whether your ...

UnityPoint Health

Chemical Dependency Counselor

Iowa City, IA · On-site

$17.50 - $24/hr

We even offer pet insurance for your four-legged family members. • Early access to earned wages ... utilization review activities necessary to obtain treatment approval. • Provides statistical data ...

UnityPoint Health

RN Lead-GuideLink Center

Iowa City, IA · On-site

$29.50 - $40/hr

We even offer pet insurance for your four-legged family members. • Early access to earned wages ... utilization review procedures. • Assists with crisis services placement, where applicable. • ...

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All JobsInsurance Utilization Reviewer JobsInsurance Utilization Reviewer Jobs in Muscatine, IA

Insurance Utilization Reviewer information

See Muscatine, IA salary details

$29.1K

$35.7K

$41.3K

How much do insurance utilization reviewer jobs pay per year?

As of Jul 31, 2026, the average yearly pay for insurance utilization reviewer in Muscatine, IA is $35,658.00, according to ZipRecruiter salary data. Most workers in this role earn between $31,900.00 and $39,400.00 per year, depending on experience, location, and employer.

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 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 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 are Insurance Utilization Reviewers?

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 job categories do people searching Insurance Utilization Reviewer jobs in Muscatine, IA look for? The top searched job categories for Insurance Utilization Reviewer jobs in Muscatine, IA are:
Insurance Utilization Reviewer jobs near you

Utilization Management CNA

Cottingham & Butler

Davenport, IA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Cottingham & Butler rating

8.6

Company rating: 8.6 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

90th of 300 rated insurance

Job description

Utilization Management Assistant
Location: Onsite in Dubuque, IA. Also accepting remote applicants.
Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!
The Utilization Management Assistant answers first level calls in Utilization Review for our Health & Wellness participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Preferred Skills
  • Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
  • Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
  • Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans

Qualifications:
  • CNA, LPN, or Medical Assistant preferred
  • Background in patient health support or care
  • 1+ years of experience within this field

Full-Time Benefits - Most benefits start day 1
  • Medical, Dental, Vision Insurance
  • Flex Spending or HSA
  • 401(k) with company match
  • Profit-Sharing/Defined Contribution (1-year waiting period)
  • PTO/Paid Holidays
  • Company-paid ST and LT Disability
  • Maternity Leave/Parental Leave
  • Subsidized Parking
  • Company-paid Term Life/Accidental Death Insurance

About Cottingham & Butler:
At Cottingham & Butler, we sell a promise to help our clients through life's toughest moments. To deliver on that promise, we aim to hire, train, and grow the best professionals in the industry. We look for people with an insatiable desire to succeed, are committed to growing, and thrive on challenges. Our culture is guided by the theme of "better every day" constantly pushing ourselves to be better than yesterday - that's who we are and what we believe in.
As an organization, we are tremendously optimistic about the future and have incredibly high expectations for our people and our performance. Our ability to grow as a company, fuels investments in new resources to better serve our clients and provide the amazing career opportunities our employees want and deserve. This is why we are a growth company and why we are committed to being better every day.
Want to learn more? Follow us on www.CottinghamButler.com | LinkedIn | Facebook

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