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Insurance Utilization Reviewer Jobs in Phoenix, AZ

UHS

Utilization Management Coordinator - PRN

Phoenix, AZ · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... utilization review department Benefits include: * Challenging and rewarding work environment ... of insurance benefits throughout the patient's stay, and assists the treatment team in ...

HOPCo

RN Case Manager - Utilization Review

Phoenix, AZ · On-site

  • Medical

  • Retirement

A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and ... Prepare and submit clinical appeals to insurance companies when services are denied, providing ...

Valenz

Utilization Management Nurse

Phoenix, AZ · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

You will review UM activities, including prospective, concurrent, and retrospective reviews, and ... Pet insurance * Employee discounts on phone plans, car rentals and computers * Community giveback ...

Aldridge Pite LLP

Title Reviewer

Mesa, AZ · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Aldridge Pite, LLP is a multi-state law firm that focuses heavily on the utilization of technology ... Company Paid Life and Disability Insurance plans * Medical, Dental and Vision Plans with ...

New

Evolent

Physician Reviewer-Radiology (Part Time)

Phoenix, AZ · On-site

$95 - $100/hr

  • Medical

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...

Healthcare Support Staffing

Clinical Pharmacist

Tempe, AZ · On-site

$113K - $135K/yr

Oversee the drug utilization review and medication therapy management programs for specialty ... Knowledge in Insurance experience (Medicare, Medicaid, commercial) * Computer skills are a MUST (MS ...

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All JobsInsurance Utilization Reviewer JobsInsurance Utilization Reviewer Jobs in Phoenix, AZ

Insurance Utilization Reviewer information

See Phoenix, AZ salary details

$30.8K

$37.7K

$43.7K

How much do insurance utilization reviewer jobs pay per year?

As of Aug 16, 2026, the average yearly pay for insurance utilization reviewer in Phoenix, AZ is $37,723.00, according to ZipRecruiter salary data. Most workers in this role earn between $33,800.00 and $41,700.00 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 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 popular job titles related to Insurance Utilization Reviewer jobs in Phoenix, AZ?

For Insurance Utilization Reviewer jobs in Phoenix, AZ, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Reviewer jobs in Phoenix, AZ look for?

The top searched job categories for Insurance Utilization Reviewer jobs in Phoenix, AZ are:

Insurance Utilization Reviewer jobs near you

Utilization Management Coordinator - PRN

UHS

Phoenix, AZ • On-site

Per diem

Medical, Dental, Vision, Retirement, PTO

Re-posted 29 days ago

Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

495th of 887 rated healthcare providers

Job description

Responsibilities
Utilization Management Coordinator
PRN- As Needed Monday - Friday (Not Remote)
Quail Run Behavioral Health Hospital in Phoenix is seeking a dynamic and talented UM Coordinator to join our team of compassionate, dedicated professionals in our utilization review department
Benefits include:
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • Tuition Assistance after 90 days of employment!
Job Summary:
The UM Coordinator contacts external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay, and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning. The UM Coordinator is responsible for having a thorough understanding of the patient's treatment through communication with the treatment team. The UM Coordinator advocates for the patient's access to services during treatment team meetings and through individual physician contact
Qualifications
Education and Experience:
  • Bachelor's prepared healthcare professional (Counseling, Psychology or Social Work) required.
    Master's preferred.
  • A minimum of two (2) years experience in a healthcare setting or managed care company, Pscyh Hospital experience preferred.
  • Must have or be able to obtain a Level 1 Fingerprint Clearance Card.

About Universal Health Services
One of the nation's largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. UHS is recognized as one of the World's Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

What Universal Health Services employees say

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US

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