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Intern Insurance Utilization Review Jobs in Rancho Cucamonga, CA

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

CVS Health

Pharmacy Intern - Grad

West Covina, CA · On-site

$17.25 - $21.25/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

CVS Health

Pharmacy Intern - Grad

Riverside, CA

$17.50 - $21.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Oak St. Health

Grad Pharmacist

Lake Arrowhead, CA · On-site

$17.25 - $21.50/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 ...

CVS Health

Grad Pharmacist

Lake Arrowhead, CA · On-site

$17.25 - $21.50/hr

As a Graduate Pharmacy Intern, you will apply your didactic learning from pharmacy school and ... quality assurance drug utilization review (DUR), pharmacy professional standards such as ...

Astiva Health, Inc

UM Nurse Reviewer

Orange, CA · On-site

Utilization Management Authorization Review Nurse Astiva Health, Inc., located in Orange, CA is a ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

The Utilization Management Authorization Review Nurse is responsible for managing inpatient ... Dental Insurance * Health Insurance * Life Insurance * Vision Insurance * Paid Time Off ...

City of Ontario

Administrative Intern - Fire

Ontario, CA · On-site

$21.18 - $26.45/hr

The first review of applications will be conducted the week of July 6, 2026. Are you interested in ... City's health insurance or retirement plans. The Ontario Fire Department The Ontario Fire ...

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All JobsIntern Insurance Utilization Review JobsIntern Insurance Utilization Review Jobs in Rancho Cucamonga, CA

Intern Insurance Utilization Review information

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

As of Aug 10, 2026, the average hourly pay for intern insurance utilization review in Rancho Cucamonga, CA is $17.14, according to ZipRecruiter salary data. Most workers in this role earn between $14.76 and $19.18 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.
What are the most commonly searched types of Insurance Utilization Review jobs in Rancho Cucamonga, CA? The most popular types of Insurance Utilization Review jobs in Rancho Cucamonga, CA are:
What cities near Rancho Cucamonga, CA are hiring for Intern Insurance Utilization Review jobs? Cities near Rancho Cucamonga, CA with the most Intern Insurance Utilization Review job openings:
Intern Insurance Utilization Review jobs near you

Utilization Specialist PRN

Acadia Healthcare

Riverside, CA • On-site

$31 - $50/hr

Per diem

Re-posted 28 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

699th of 887 rated healthcare providers

Job description

Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are a private inpatient 68 bed acute psychiatric facility with out-patient services, dedicated to the treatment of behavioral health and substance abuse services. Come join TEAM PGH as a UR Specialist!

  • Flexible scheduling
  • Competitive Pay
  • Employee Assistance Program (EAP)

Hourly pay range: $31-50 DOE and licensure held

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  


ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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