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Remote Insurance Utilization Review Jobs in Delaware

ChristianaCare

Coding Coordinator IV - (Remote)

Newark, DE · On-site +1

$32.77 - $52.43/hr

Timely prebill review and audit patient medical records (inpatient primarily) and correctly capture ... Full Medical, Dental, Vision, Life Insurance, etc. * 403(b) with company match. * Generous paid ...

ABB

Data Center COE Project Management Leader

DE · Remote

$119K - $190K/yr

Remote in the US This role is contributing to the ELSE Data Center Services Center of Excellence in ... through reviews, proper project closure, KPI achievement (revenue, utilization, margin ...

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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 popular job titles related to Remote Insurance Utilization Review jobs in Delaware? For Remote Insurance Utilization Review jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Delaware look for? The top searched job categories for Remote Insurance Utilization Review jobs in Delaware are:
What cities in Delaware are hiring for Remote Insurance Utilization Review jobs? Cities in Delaware with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Delaware as of July 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% Remote job distribution.
Insurance Coordinator II | HomeHealth

Insurance Coordinator II | HomeHealth

Christiana Care Health Services

Wilmington, DE • On-site, Remote

$19.84 - $29.76/hr

Full-time

Medical, Retirement, PTO

Posted 4 days ago

Job description

Job Details
Build a career that helps keep care moving forward. As an Insurance Coordinator, you'll leverage your insurance expertise and problem-solving skills while collaborating with a supportive team to ensure patients can access the care they need. Your contributions will play a critical role in supporting quality patient care throughout the home health journey.

Christiana Care's Home Healthcare Division, the Visiting Nurse Association (VNA) serves patients across the entire State of Delaware. We are currently seeking a full time, Insurance Coordinator to join our team and verify, document, and review insurance cases as well as maintain and update required authorizations for on-going insurance verification as assigned. The successful candidate will work a part-time schedule of 20 hours per week, Monday thru Friday, between 8am to 4:30pm, with no weekend or holiday commitment.This position offers the potential for a hybrid or remote work schedule following the successful completion of the 90-day introductory period.


The successful candidate will:

  • Verify insurance eligibility of all managed care cases assigned; leveraging websites like Navinet, Availity and Pear Portal as well as direct contact with payers.
  • Obtain pre-certification and on-going authorizations as required for all managed care cases assigned
  • Maintain insurance authorization tracking through clear, accurate documentation of all pertinent information
  • Ensure authorizations are timely and accurately entered into the patient's account
  • Review and update open authorizations that create a claims auth hold to ensure claims are released

Education and experience requirements:

  • High School diploma required
  • Proficient in Microsoft Office Suite (Outlook, Word, Excel), and electronic healthcare systems, with strong typing and computer navigation skills required
  • Experience with medical insurance verification, authorization management, and payer requirements required (3-5 years)
  • Home Care experience preferred (3-5 years)
  • Effective time management and problem-solving abilities a must
  • Ability to implement new ideas, accepting of constructive feedback
Hourly Pay Range: $19.84 - $29.76This pay rate/range represents ChristianaCare's good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

Jul 24, 2026

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/

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About ChristianaCare

Sourced by ZipRecruiter

ChristianaCare is one of the country's most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as a Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

Industry

Outpatient health care

Company size

10,000+ Employees

Headquarters location

Wilmington, DE, US

Year founded

1888

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