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Intern Insurance Utilization Review Jobs (NOW HIRING)

KPC Health

Utilization Review Tech

Santa Ana, CA

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the ... Reviews treatment plans and status of approvals from insurers. Collects and compiles data as ...

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PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!

Oscar Health

Utilization Review Nurse

Tempe, AZ · 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 ...

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We ...

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

As of Jun 1, 2026, the average hourly pay for intern insurance utilization review in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Intern in Insurance Utilization Review, and why are they important?

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 are some typical responsibilities for an Intern in Insurance Utilization Review and how do they contribute to the team?

As an Intern in Insurance Utilization Review, you’ll typically assist the team by gathering patient medical records, verifying insurance coverage, and preparing documentation for case reviews. You may also help with the initial assessment of claims or authorizations under the guidance of experienced reviewers. These tasks are essential for ensuring that claims are processed efficiently and in compliance with payer requirements. Interns often collaborate closely with clinical reviewers, case managers, and billing specialists, gaining valuable exposure to healthcare operations and insurance processes.

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 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 cities are hiring for Intern Insurance Utilization Review jobs? Cities with the most Intern Insurance Utilization Review job openings:
What are the most commonly searched types of Insurance Utilization Review jobs? The most popular types of Insurance Utilization Review jobs are:
Intern Insurance Utilization Review jobs near you
Utilization Review Tech

Utilization Review Tech

KPC Health

Santa Ana, CA

Full-time

Posted 15 hours ago

Job description

Utilization Review Technician

Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being responsible for coordinating phone calls, clinical requests, upkeeps data entry, organizes denials and mailing/faxing appeals, tracking data from various insurance providers and health plans regarding authorization and/or denials, expedite reviews and documentation to insurance providers. Monitors patient charts and records to provide to responsible parties and request for authorization for hospital admission. Reviews treatment plans and status of approvals from insurers. Collects and compiles data as required and according to applicable policies and regulations. Performs administrative duties for the Utilization Management Department, and directed in several aspects of duties. Position is non-RN/LVN.

Requirements

  • Ability to establish and maintain effective working relationships across the Health System
  • Ability to interpret and understand various medical insurance plans and make accurate determinations regarding coverage
  • Follow up with insurance companies regarding the status of outstanding claims and necessary steps for resolution
  • Answer and review pertinent insurance correspondence to ensure complete and accurate reimbursement for medical claims
  • Responsible for working payer correspondence, edits and aged account receivable, and identifying and correcting billing errors
  • Pull daily reports utilizing Microsoft Excel and providing correct correspondence to payer
  • Research payer rules and regulations to maintain current payer knowledge
  • Comply with HIPAA and other compliance requirements to protect patient confidentiality
  • Manage data in internal and external databases with accuracy
  • Provide high-level administrative support and assistance to the Director and Supervisor or other assigned leadership staff
  • Perform clerical and administrative tasks including drafting letters, memos, invoices, reports, and other documents for senior staff
  • Prepare patient charts for medical audits

Education & Experience Requirements:

  • High School Diploma
  • Healthcare experience strongly preferred

Skills & Abilities Requirements:

  • Excellent verbal and written communication skills
  • Excellent organizational skills and attention to detail
  • Excellent time management skills with a proven ability to meet deadlines
  • Ability to function well in a high-paced and at times stressful environment
  • Extensive knowledge of office administration, clerical procedures, and recordkeeping systems
  • Able to type minimum of 50 words per minute
  • Knowledge of CMS, State Regulations, URAC and NCQA guidelines preferred.
  • ICD-10 and CPT coding experience a plus
  • Experienced computer skills with Microsoft Word, Microsoft Outlook, Excel and experience working in a health plan medical management documentation system a plus
  • Extremely proficient with Microsoft Office Suite or similar software with the ability to learn new or updated software
  • Medical Terminology preferred

Physical Requirements:

  • Body Positions: Sitting and standing for prolonged periods.
  • Body Movements: Arm and hand dexterity.
  • Body Senses: Must have command of close and distant sight, color perception and hearing.
  • Strength: Ability to lift and move up to 25-pounds.

Working Environment:

  • Work in an office, where the climate is controlled.
  • OSHA exposure category: II
  • Category I – Position includes tasks that involve exposure to Blood borne Pathogens.
  • Category II – Position includes tasks that do not have exposure to Bloodborne Pathogens, however employment may require unplanned Category I tasks.
  • Category III – Positions includes tasks that do not involve exposure to Bloodborne Pathogens. This position would not be required to perform Category I tasks.
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About KPC Health

Sourced by ZipRecruiter

KPC Health has an integrated approach to serving the people of Riverside, San Bernardino and Orange County. Our acute care medical centers provide high quality, comprehensive and affordable healthcare for the entire family. For us, healthcare is not just about caring for our patients, but also about investing in the people throughout our communities. We are one team with one mission and that mission is for all our patients, and their families to Enjoy Life in Great Health.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Santa Ana, CA, US

Year founded

2004

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