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Intern Insurance Utilization Review Jobs in Boca Raton, FL

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...

SBT

Be Seen First

Utilization Review (UR) Specialist

Boca Raton, FL · On-site

$60K - $70K/yr

Utilization Review (UR) Specialist Location: Boca Raton, FL Job Type: Full-time, In-Person Pay: $60 ... Work collaboratively with insurance providers, care managers, clinicians, admissions teams, and ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

Must be familiar with a variety of insurances and funding streams, including commercial insurance ... Utilization Review position, such as: * Challenging and rewarding work environment * Competitive ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director of Utilization Management is also responsible for ensuring that the utilization review ... Must be familiar with a variety of insurances and funding streams, including commercial insurance ...

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Two years of UR experience in a hospital or healthcare insurance setting required. LICENSURE ...

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site +1

$60K - $75K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Two years of UR experience in a hospital or healthcare insurance setting required. LICENSURE ...

Oak St. Health

Grad Pharmacist

Hollywood, FL · On-site

$15.25 - $19/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

Lake Worth Beach, FL · On-site

$15 - $18.50/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

Riviera Beach, FL · On-site

$16.25 - $20.25/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Oak St. Health

Grad Pharmacist

West Palm Beach, FL · On-site

$16.25 - $20/hr

Graduate Pharmacy Intern You've invested a lot of time and energy in your education. Now you want ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

genex

Telephonic Case Manager

Boca Raton, FL · On-site

Interface with external agencies/representatives relative to the utilization review process including, but not limited to, Third-Party Payers, Insurance Companies and Providers. Perform Utilization ...

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All JobsIntern Insurance Utilization Review JobsIntern Insurance Utilization Review Jobs in Boca Raton, FL

Intern Insurance Utilization Review information

See Boca Raton, FL salary details

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How much do intern insurance utilization review jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for intern insurance utilization review in Boca Raton, FL is $15.92, according to ZipRecruiter salary data. Most workers in this role earn between $13.70 and $17.79 per hour, depending on experience, location, and employer.

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.

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 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.
Intern Insurance Utilization Review jobs near you

Utilization Review Nurse

Health Business Solutions LLC

Cooper City, FL

Full-time

Posted 26 days ago

Job description

Job Summary: We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a crucial role in supporting our clients in the healthcare industry by providing expert clinical guidance, facilitating effective utilization management, and ensuring revenue cycle efficiency. This position offers a unique opportunity to combine clinical expertise with revenue cycle management knowledge.

Key Responsibilities:

· Clinical Assessment: Conduct comprehensive clinical assessments of medical records to ensure patients are receiving appropriate care at the correct level of service.

  • Care Coordination: Collaborate with interdisciplinary healthcare teams to coordinate patient care and treatment plans, ensuring the most cost-effective and clinically appropriate care is provided.
  • Revenue Cycle Management: Utilize clinical expertise to support revenue cycle processes, including accurate coding, documentation improvement, and compliance with healthcare regulations.
  • Utilization Review:

a) Apply medical necessity screening criteria and clinical knowledge to ensure appropriateness of admissions and length of stays

b) Conduct initial admission, continuing stay, and 23-hour observations reviews for all patients

c) Support Utilization Review Coordinator team members on cases escalated for level of care determinations

d) Screen cases for Physician Advisor review

e) Collaborate with insurance companies on concurrently denied and high risk for denial cases

  • Documentation Improvement: Identify opportunities for improving clinical documentation to support accurate coding and billing processes, ultimately improving reimbursement.


  • Data Analysis: Analyze clinical and financial data to identify trends, opportunities for improvement, and areas of potential cost savings for clients.


  • Compliance: Stay up-to-date with healthcare regulations, guidelines, and policies to ensure all patient care and revenue cycle processes are in compliance with industry standards and regulatory requirements to ensure appropriate reimbursement.

Qualifications:

· Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact nursing license.

· Bachelor of Science in Nursing (BSN) preferred.

· Case Management Certification (e.g., CCM) is a plus.

· Minimum of 3 years of clinical nursing experience, preferably in a hospital or acute care setting.

· Minimum 2 years of work experience in Utilization Review

· Strong understanding of revenue cycle management and healthcare reimbursement.

· Proficiency in medical coding and clinical documentation improvement.

· Excellent communication, interpersonal, and teamwork skills.

· Ability to work independently and make sound clinical and financial decisions.

· Strong analytical and problem-solving skills.

· Proficient in using healthcare information systems and technology.

· Commitment to maintaining patient confidentiality and ethical standards.

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