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Intern Insurance Utilization Review Jobs in Texas

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

... insurance or managed care industry using medically accepted criteria to validate the medical ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Actalent

Utilization Review Nurse

Houston, TX · On-site

$30 - $40/hr

Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for ... Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term ...

Medix

Utilization Review Nurse

Fort Worth, TX · On-site

$38.46 - $43.27/hr

Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role ... Term Life Insurance Plan. Required Employment / Compliance Language * We will consider for ...

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Intern Insurance Utilization Review information

What does an intern insurance utilization review do?

An Intern Insurance Utilization Review assists with evaluating medical records and insurance claims to ensure that healthcare services are medically necessary and covered by insurance policies. They work under supervision to review documentation, communicate with healthcare providers, and help determine if treatments meet established guidelines. This role provides valuable exposure to the insurance and healthcare industries, helping interns learn about claims processing, policy compliance, and the importance of cost-effective care.

What skills and qualifications are needed to thrive as an intern insurance utilization review?

To thrive as an Intern in Insurance Utilization Review, you typically need a background in healthcare administration or a related field, along with strong analytical and organizational skills. Familiarity with electronic health records (EHRs), insurance databases, and claims processing systems is often required. Attention to detail, effective communication, and the ability to collaborate with both clinical and administrative teams are essential soft skills. These competencies ensure accurate review of insurance claims, compliance with regulations, and efficient coordination between healthcare providers and insurers.

What is the difference between Intern Insurance Utilization Review vs Insurance Claims Processor?

AspectIntern Insurance Utilization ReviewInsurance Claims Processor
CredentialsTypically pursuing or holding a relevant degree (e.g., health administration, nursing)High school diploma or equivalent; some roles may require insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or administrative officesInsurance companies, healthcare providers, or claims processing centers
Primary ResponsibilitiesAssisting in reviewing medical necessity, supporting utilization review processesProcessing and reviewing insurance claims for accuracy and completeness

Intern Insurance Utilization Review focuses on evaluating medical necessity and supporting healthcare decision-making, often involving review of patient records. Insurance Claims Processors handle the administrative task of reviewing and processing insurance claims for payment. While both roles involve insurance and healthcare, utilization review emphasizes clinical assessment, whereas claims processing centers on administrative claim management.

How do I get into an intern insurance utilization review?

To become an intern in insurance utilization review, candidates typically need to be enrolled in or have recently completed a relevant healthcare or insurance-related program, such as health administration or nursing. Gaining knowledge of medical terminology, insurance policies, and utilization review processes, along with strong analytical skills, is important; some positions may require certification or training in healthcare quality or case management. Internships are often offered through insurance companies, healthcare organizations, or hospitals and may require applying through their career portals or internship programs.

Is utilization review a stressful job?

Utilization review as an intern involves evaluating insurance claims and determining appropriate care, which can be demanding due to strict deadlines and the need for accuracy. The role requires attention to detail and knowledge of insurance policies, but stress levels vary depending on workload and individual coping skills.

What are the most commonly searched types of Insurance Utilization Review jobs in Texas?

The most popular types of Insurance Utilization Review jobs in Texas are:

What cities in Texas are hiring for Intern Insurance Utilization Review jobs?

Cities in Texas with the most Intern Insurance Utilization Review job openings:

Intern Insurance Utilization Review jobs near you

Utilization Review Assistant

Odessa, TX • On-site

Medical Center Hospital
Health Care and Social Assistance • 1 - 5K employees

8.4

Company rating: 8.4 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

25th of 895 rated healthcare providers

People enjoy working here

Good employer

Recommended by parents

Learn more about Medical Center Hospitalexternal

Part-time

Re-posted 11 days ago

Job description

Position Summary:
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.
Qualifications:
A. Education:
Must have a high school diploma or equivalent.
B. Training and Experience:
Must have a minimum of one-year work experience in an acute care medical facility.
C. Job Knowledge:
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing.
Unusual Physical Demands and Working Conditions:
Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance preferred.
Ability to communicate effectively and professionally, both verbally and in writing.

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