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Intern Insurance Utilization Review Jobs (NOW HIRING)

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 ...

Uniti Med

Travel Utilization Review

Tewksbury, MA · On-site

Uniti Med is seeking a travel Utilization Review for a travel job in Tewksbury, Massachusetts ... Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to: Director of Revenue ... Coordinate with insurance companies by submitting all required documentation and addressing any ...

UHS

Utilization Review Coordinator

Brookline, MA

Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time ... insurance offering, a physician network and various related services located in 40 U.S. states ...

UHS

Utilization Review Coordinator

Brookline, MA

Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time ... insurance offering, a physician network and various related services located in 40 U.S. states ...

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

As of Jul 20, 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 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 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 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 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 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:
What states have the most Intern Insurance Utilization Review jobs? States with the most job openings for Intern Insurance Utilization Review jobs include:
Intern Insurance Utilization Review jobs near you
Utilization Review Physician

Utilization Review Physician

Dane Street, LLC

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Job description

Overview
We are seeking a high-performing Physician Reviewer to join our Group Health division. The role is responsible for delivering timely, defensible utilization review determinations across a high-volume, fast-paced environment. Reviews span multiple case types, including preauthorization, appeals, DRG clinical validation, benefit review, and experimental/investigational determinations.
Key Responsibilities
  • Perform utilization review for:
    • Preauthorization requests
    • Appeals (first and second level)
    • Independent external reviews
    • DRG validation and clinical review
    • Benefit and coverage determinations
    • Experimental/Investigational (E/I) review
  • Apply evidence-based criteria and guidelines, including:
    • InterQual
    • MCG
    • CMS guidelines (including 2-Midnight Rule)
    • LCD/NCD
    • Client-specific policies
  • Produce clear, concise, and defensible clinical rationales
  • Maintain high accuracy and consistency across determinations
  • Meet or exceed turnaround time (TAT) expectations, including urgent cases
  • Participate in peer-to-peer discussions as needed
  • Collaborate with QA and operational teams to ensure quality and compliance
  • Reviews may be conducted within internal systems or client-specific platforms, depending on assignment and client requirements

Performance Metrics
  • High daily review volume with strong accuracy
  • Consistent adherence to client-specific requirements
  • Ability to manage short-TAT and urgent cases efficiently
  • Clear, audit-ready documentation

Required Qualifications
  • MD or DO, board-certified in Internal Medicine, Family Medicine, or similar
  • Active, unrestricted medical license
  • Prior utilization review experience, preferably in a health plan or IRO environment
  • Familiarity with InterQual, MCG, and CMS guidelines
  • Strong clinical judgment and documentation skills
  • Ability to work independently in a high-throughput environment

Technical Skills
  • Proficiency with standard business tools (e.g., Google Workspace, Microsoft Office)
  • Comfortable working across multiple systems, including internal platforms and client-specific portals
  • Strong navigation and documentation skills within web-based applications
  • Ability to manage multiple systems/screens simultaneously in a high-throughput environment
  • Familiarity with Mac operating systems

Work Environment
  • Remote work from home
  • Full-time, Monday-Friday
  • Availability for occasional weekends and holiday coverage for urgent reviews

Benefits
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

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