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Remote Insurance Utilization Review Jobs in Delaware

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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 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 August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 21% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.

Licensed Professional Counselor (LPC)

Gotham Enterprises Ltd

Bethany Beach, DE • On-site, Remote

$115K - $120K/yr

Full-time

Medical, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Licensed Professional Counselor (LPC) Opportunity
Location: Louisiana
Setting: Remote/Telehealth
Position: Full-Time
Salary: $115,000 to $120,000 a year
Schedule: Monday-Friday, 9:00 AM - 5:00 PM
Job Summary:
A full-time opening is available for a Licensed Professional Counselor (LPC) who wants to deliver meaningful mental health care in a remote setting. This role focuses on helping clients manage stress, anxiety, depression, life transitions, and other behavioral health concerns through scheduled virtual sessions. You will play a key part in guiding treatment, tracking progress, and giving clients practical support they can apply in daily life.
Responsibilities:
  • Conduct virtual therapy sessions for adults, teens, or families based on assigned caseload
  • Perform intake assessments and gather relevant clinical history
  • Create treatment plans with realistic and measurable goals
  • Maintain compliant clinical notes and case records
  • Review client progress and modify care plans as appropriate
  • Provide crisis support and proper referrals when needed
  • Educate clients on coping skills and treatment strategies

Requirements
  • Master's degree in Counseling or a related mental health field
  • Active LPC license in Louisiana
  • Experience providing counseling services in a clinical or telehealth setting
  • Strong assessment, communication, and documentation skills
  • Ability to manage a full-time caseload independently

Benefits
  • 2 weeks PTO
  • Health Insurance
  • 401K Plan with 3% Company Match

Take the next step in your counseling career with a role built for both impact and stability.
Gotham Enterprises logo

About Gotham Enterprises

Sourced by ZipRecruiter

Gotham Enterprises, Ltd., headquartered in Queens/Fresh Meadows, NY, is a healthcare and mental‑health staffing and job placement platform that connects licensed professionals (psychiatrists, nurse practitioners, therapists, medical assistants, allied health) with in‑person, contract, per‑diem, and permanent assignments across New York State. Working through its job portal and regional offices, Gotham serves outpatient clinics, home‑care agencies, schools, and community health centers, offering roles including Licensed Mental Health Counselors (LMHC), Psychiatric–Mental Health Nurse Practitioners (PMHNP), PAs, and clinic support staff. The company is actively recruiting and retains a distributed workforce with both in‑office and remote recruiters; salaries for PMHNP roles average ~$160,000/year.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Montclair, NJ, US

Year founded

2016

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