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Rate Reviewer Jobs in Michigan (NOW HIRING)

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of ... rate. * As a job position within our Care Management division, a successful completion of a ...

Linkedin-US

Commercial Rater

Clinton Township, MI · On-site

The Commercial Rater is responsible for reviewing insurance applications, gathering required information, and accurately rating commercial policies according to established guidelines and carrier ...

New

Quala

Cargo Tank Inspector

Gibraltar, MI · On-site

$15 - $16/hr

Skill-based pay rate reviews and potential increases every 6 months. Demonstrated skill in most of the following areas: * The ability to diagnose failures and make repairs on mechanical, electrical ...

Custom Home Health Inc

OASIS REVIEW SPEC

Troy, MI · On-site

Remote OASIS Reviewer Join Custom Home Health's Quality team as a contingent OASIS Review ... Conduct inter-rater reliability reviews when applicable * Assist with additional chart audits as ...

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Showing results 21-40

All JobsRate Reviewer JobsRate Reviewer Jobs in Michigan

Rate Reviewer information

What is a rate reviewer?

Rate Reviewers are professionals who evaluate and analyze proposed rates, often within industries like insurance, utilities, or healthcare. Their primary responsibility is to ensure that rates set by companies are fair, reasonable, and comply with regulatory standards. They review detailed documentation, financial data, and justifications for rate changes to protect consumer interests and maintain industry transparency. Rate Reviewers often work for government agencies, regulatory bodies, or large organizations.

What are the key skills and qualifications needed to thrive as a rate reviewer, and why are they important?

To thrive as a Rate Reviewer, you need strong analytical abilities, attention to detail, and a background in finance, insurance, or a related field—often supported by a bachelor's degree. Familiarity with regulatory compliance tools, actuarial software, and data management systems is typically required. Excellent written communication, objectivity, and organizational skills help you navigate complex regulations and present findings clearly. These competencies ensure accurate rate assessments, regulatory compliance, and effective collaboration with stakeholders.

What are some common challenges faced by rate reviewers and how can they be managed effectively?

Rate Reviewers frequently encounter the challenge of analyzing complex data sets and ensuring compliance with evolving regulatory standards. Staying current with industry regulations and maintaining strong attention to detail are essential for success. Effective collaboration with actuaries, underwriters, and regulatory agencies also helps to resolve discrepancies and ensure accurate rate filings. Developing strong analytical and communication skills can help Rate Reviewers address these challenges and contribute to the organization's compliance and profitability.

What is the difference between Rate Reviewer vs Claims Adjuster?

AspectRate ReviewerClaims Adjuster
Required CredentialsTypically a high school diploma or equivalent; some roles prefer insurance or finance certificationsHigh school diploma or equivalent; often requires state licensing or certification
Work EnvironmentOffice-based, reviewing insurance rates and policiesField and office-based, investigating and settling insurance claims
Employer & Industry UsageInsurance companies, financial institutionsInsurance companies, public agencies
Comparison Search IntentUnderstanding role differences, job requirements, or career pathsComparing job responsibilities, qualifications, or career options

Both roles are integral to the insurance industry, but a Rate Reviewer primarily evaluates and approves insurance rates, while a Claims Adjuster investigates and settles claims. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

What are popular job titles related to Rate Reviewer jobs in Michigan?

For Rate Reviewer jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Rate Reviewer jobs in Michigan look for?

The top searched job categories for Rate Reviewer jobs in Michigan are:

What cities in Michigan are hiring for Rate Reviewer jobs?

Cities in Michigan with the most Rate Reviewer job openings:

Rate Reviewer jobs near you
Infographic showing various Rate Reviewer job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 68% Full Time, 21% Part Time, 1% Temporary, 7% Contract, and 2% Nights. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Utilization Review Nurse

Medix

Southfield, MI • On-site

$42 - $46/hr

Part-time

Medical, Dental, Vision, Retirement

Re-posted 3 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical documentation, performing quality assurance on physician reports, and collaborating with various teams to ensure accurate and timely case handling.
Key Responsibilities
  • Manage the full lifecycle of IRO cases from intake through final case closure.
  • Review incoming clinical documentation, verify completeness, and prepare concise case summaries for physician reviewers.
  • Coordinate and route cases to the appropriate physician specialty while managing requests for additional medical records.
  • Perform quality assurance on physician reports to ensure accuracy, clarity, completeness, and defensibility.
  • Monitor regulatory deadlines and case status to ensure timely, compliant case completion.
  • Maintain accurate case tracking and documentation within internal systems and state IRO programs.
  • Collaborate with physicians, clients, and internal teams to resolve documentation gaps and support case progression.
  • Contribute to workflow improvements, new state program implementation, and process optimization as the organization grows.

Qualifications
  • Active RN license and BSN required.
  • Experience with Independent Review Organizations (IROs), or Utilization Review/Appeals within a Health Plan or TPA.
  • Strong clinical documentation review, case summary writing, and QA skills.
  • Excellent written communication with exceptional attention to detail.
  • Ability to independently manage multiple cases while meeting regulatory timelines.

Skills
  • Technical: Proficiency in clinical documentation review and case summary writing.
  • Soft: Strong written communication, attention to detail, and independent case management skills.

Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
* As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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