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Remote Insurance Utilization Review Jobs in Idaho

firsthand Health

Remote Triage Nurse

Boise, ID · On-site +1

$80K/yr

... are utilization. Together with our health plan partners, we are changing the way our society ... Such requests will be subject to review and approval by the Company, and exemptions will be granted ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Idaho

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 Idaho? For Remote Insurance Utilization Review jobs in Idaho, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Idaho look for? The top searched job categories for Remote Insurance Utilization Review jobs in Idaho are:
What cities in Idaho are hiring for Remote Insurance Utilization Review jobs? Cities in Idaho 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 Idaho as of July 2026, with employment types broken down into 83% Full Time, and 17% Temporary. Highlights an 100% Remote job distribution.

Licensed Property & Casualty Insurance Producer - Fully remote

ADVENTURE CLUB INSURANCE LLC

Meridian, ID • Remote

$36K/mo

Full-time

Re-posted 27 days ago

Job description

As ACI's continues to grow, we are continually seeking top-performing and dynamic Licensed Property & Casualty Insurance Producers to sell RV/Home/Auto insurance coverage to inbound insurance quote requests. This job is for you if you’re driven to exceed goals and produce top results, curious and growth-minded, a team player, committed to being a champion for your customers, and a rockstar in communication and relationship building. This role is fully remote. Pay target: $36,000 + commission based on performance!

WITHIN 1 MONTH, YOU WILL:

  • Be an expert in ACI’s insurance coverage options, policy details, and best practices
  • Uphold all ACI selling and marketing standards and processes, ensuring agency management systems and tools stay current and accurate
  • Field inbound insurance quote requests and inquiries. Listen to customers’ needs, weigh solutions, and provide educated, win-win recommendations
  • Make a minimum of 30 outbound customer contacts per day
  • Provide excellent, professional customer service and cultivate genuine relationships with customers
  • Complete company-paid carrier training and ACI training
  • Understand and lean into ACI’s culture and values
  • Be an expert at balancing the day-to-day responsibilities

WITHIN 3 MONTHS, YOU WILL:

  • Successfully develop relationships across the organization
  • Engage with and enrich sales team culture by being available to your teammates for advice, collaboration, and assistance.
  • Make a minimum of 50 outbound customer contacts per day
  • Understand team and business dynamics, then make autonomous decisions that are good for the customer, the company, yourself, and the team
  • Develop and achieve individual sales and growth goals

WITHIN 12 MONTHS, YOU WILL:

  • With the team, meet and exceed targeted sales goals in RV/Home/Auto insurance coverage via both inbound and outbound channels, contributing to the overall growth of the agency
  • Expand client base through the creation of a trusted personal brand
  • Implement client retention strategies, such as regular check-ins, policy reviews, and educational workshops
  • Develop personalized communication plans for key clients to enhance relationships and encourage referrals
  • Complete 20-hour continuing education licensing requirements (annually)
  • In collaboration with ACI’s leaders, build, implement, and regularly review a personal strategic growth plan that aligns with the agency’s goals

WHAT WE’RE LOOKING FOR IN YOU:

  • Minimum 1 year of experience in insurance sales, plus valid P&C license (required)
  • Ability to thrive in remote-work environment
  • Strong basic computer and technology skills (Microsoft office)
  • History of reaching goals and achieving consistent results
  • Love and commitment for personal learning and growth
  • Team-oriented and “we” mindset that recognizes the value and strength of team effort
  • Belief in “fun with a purpose” and a positive leader of peers
  • A customer-obsessed attitude and work ethic that goes the extra mile to support customers
  • Exceptional skill in the “art” of relationship building and communication

WHAT YOU’LL GET FROM US:

  • Competitive pay: salary + commission (top performers make $200k+!)
  • Competitive bonus opportunities
  • Opportunity for promotion within the company as we grow
  • Excellent Individual and Family Benefits
  • Health, Vision/Dental, Short- and Long-term disability, HAS
  • 401K with aggressive company match