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Remote Insurance Utilization Review Jobs in California

CorVel

UR Intake Specialist

Rancho Cucamonga, CA · Remote

$16.90 - $26.92/hr

... Utilization Review / Case Management department, and of CorVel. This is a remote position ... Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and ...

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Remote Insurance Utilization Review 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.

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 are remote insurance utilization review jobs?

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 are the key skills and qualifications needed to thrive as a Remote Insurance Utilization Review Specialist, and why are they important?

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.
What are the most commonly searched types of Insurance Utilization Review jobs in California? The most popular types of Insurance Utilization Review jobs in California are:
What are popular job titles related to Remote Insurance Utilization Review jobs in California? For Remote Insurance Utilization Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in California look for? The top searched job categories for Remote Insurance Utilization Review jobs in California are:
What cities in California are hiring for Remote Insurance Utilization Review jobs? Cities in California with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you

UR Intake Specialist

CorVel

Rancho Cucamonga, CA • Remote

$16.90 - $26.92/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 50 frontline employees who took The Breakroom Quiz

82nd of 138 rated financial services

Job description

The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming telephone calls, supporting the goals of the Utilization Review / Case Management department, and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Takes calls relating to precertification requests
  • Verifies that all patient, provider and facility information entered in system is accurate and up to date
  • Enters notes and service requests in CareMC system
  • Communicates with stakeholders in a timely and professional manner
  • Additional duties as assigned
KNOWLEDGE & SKILLS:
  • Ability to handle multiple priorities in a high-volume, fast-paced, team-oriented environment
  • Excellent written and verbal communication skills
  • Ability to meet designated deadlines
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Strong interpersonal, time management and organizational skills
  • Ability to remain poised in stressful situations and communicate diplomatically via all methods of communication
  • Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
  • High School diploma or equivalent required
  • A.A. degree or equivalent preferred

PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $16.90 - $26.92 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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