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Remote Insurance Utilization Review Jobs in Arkansas

CareAbout

Remote Reporting Relationships: This position reports to CareAbout Health's SVP Medical Economics ... review, issue escalation, timely follow-up, and coordination with internal stakeholders.

USAble Life

Go-To-Market Manager - Remote

Little Rock, AR · On-site +1

$82K - $115K/yr

Please review these qualifications carefully before applying. This role is best suited for ... Experience within the health or ancillary insurance industry. * Proven success leading cross ...

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Remote Insurance Utilization Review information

What is a remote insurance utilization review?

Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.

What skills and qualifications are needed for a remote insurance utilization review specialist?

To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.

How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?

Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.

What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?

AspectRemote Insurance Utilization ReviewRemote Claims Reviewer
CredentialsTypically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professionalUsually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H
Work EnvironmentRemote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of servicesRemote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance
Industry UsageCommonly used in healthcare insurance to evaluate medical necessityUsed across insurance sectors to process and validate claims

Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.

What are popular job titles related to Remote Insurance Utilization Review jobs in Arkansas?

For Remote Insurance Utilization Review jobs in Arkansas, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Utilization Review jobs in Arkansas look for?

The top searched job categories for Remote Insurance Utilization Review jobs in Arkansas are:

Remote Insurance Utilization Review jobs near you

Remote Start / Accessory Installer

Landers Toyota

Little Rock, AR • Remote

$17.25 - $21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 2 days ago

Job description

Remote Start / Accessory Installer

We are seeking Technician to join our team. Our high volume shop is fast-paced, productive and a great work atmosphere! Our small team structures allow for flexible scheduling, ongoing training and plenty of work to share. OEM certifications are encouraged!

Responsibilities

  • Install Remote Start Systems / Accessories specified on the repair order with efficiency.
  • Communicate directly with the Service Advisor so that customers can be informed if any additional service is needed.  Providing an estimate of time needed for additional repairs.
  • Will train the right individual.

Qualifications

  • ASE certifications are ideal
  • Strong automotive background
  • Strong teamwork skills
  • Willing to submit to a background check
  • Must have clean & valid driver's license

What We Offer

  • Medical, Dental & Vision
  • 401k with Match
  • Paid Vacation
  • Growth Opportunities
  • Family Owned and Operated
  • Long Term Job Security
  • Health and Wellness
  • Accident & Critical Illness
  • HSA/Flexible Spending
  • Pet Insurance
  • Employee Discounts
  • State of the Art Facility
  • Busy Shop

Offers of employment are contingent upon successfully passing a background screening including a criminal background check, a review of motor vehicle records, and verification of social security number.

Apply