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Remote Insurance Utilization Review Jobs in Idaho

Integrityfex

Account Representative

Idaho Falls, ID · Remote

Account Represntative Remote | Flexible Schedule Integrity FEX is hiring Account Representatives to assist clients with reviewing life insurance options designed to help protect their loved ones. If ...

Vantor

Please review the job details below. Vantor is seeking an experienced ISR Collection Analyst to ... Monitor ISR collection activities to ensure effective utilization of available resources and ...

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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 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 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 August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Remote Healthcare Support Representative

Liveops

Caldwell, ID • Remote

Contractor

Re-posted 3 days ago

Job description

Healthcare Support Representative — Independent Contractor

Location: Remote (US-Based)

Make a difference—one call at a time, with the freedom to serve on your terms. Join a network of self-employed professionals supporting patients and/or providers, helping people get the care and answers they need while enjoying flexibility.

As an Independent Contractor, you will
  • Be your own boss.
  • Choose when and to whom you provide support services.
  • Set your own schedule.
  • Provide a distraction-free home office.
  • Provide your own home office equipment.
  • Handle customer calls, assess needs, and solve problems.
Requirements
  • At least 1 year of phone-based healthcare patient or provider support experience.
  • Computer skills, including navigating multiple systems and documenting call notes.
  • Strong communication skills and the ability to connect with diverse individuals.
  • Ability to sit for long periods.
  • Patience and empathy.
  • Ability to provide services pursuant to your contract independently.
Preferred Qualifications
  • Experience in healthcare or related fields such as medical, social services, education, mental health services, or other relevant “people helping” fields.
  • In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired.
  • Comfortable with medical and health insurance terminology while refraining from offering medical advice.
Compensation
  • Submit invoices and receive payment for completed services pursuant to contract.
  • Pay structures vary by client program; most programs pay for productive time and may include performance-based pay.
  • Independent Contractors are responsible for their own taxes and expenses.
Application & Certification Process
  • Complete an application and pass a background check.
  • Sign an Independent Contractor Agreement.
  • Complete a W-9 form and set up direct deposit.
  • Complete program-specific certifications.
Background Check

The background check requires a non-refundable $25 processing fee paid directly to the background check vendor. View background requirements

Computer Requirements
  • Some clients may require additional security measures and equipment.
  • Wired internet connection.
  • Android or Apple phone.
  • Provide your own equipment, including a Windows operating PC (Macs, Chromebooks, and tablets are not supported).
  • Review basic technology requirements
Hours
  • Choose your own schedule by self-scheduling 30-minute blocks.
  • Client hours of operation will vary.
Important Notes
  • Additional checks regarding OIG/SAM exclusion lists may be required by clients.
  • Some clients and programs may have additional requirements and certifications.
  • Ensure the clients you choose align with your availability and commitments.
Eligible States

Liveops is currently accepting applications in: AL, AK, AZ, DC, DE, FL, GA, IA, ID, IN, KS, KY, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, PA, RI, SC, SD, TN, TX, VA, WV, WY.

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About Liveops

Sourced by ZipRecruiter

Liveops, a virtual contact center, offers scalable, on-demand experiences through the VirtualFlex platform for both planned and unplanned CX needs. This tech-enabled, data-powered platform inspires and motivates brand-certified agents to deliver better experiences and attracts entrepreneurial US-based professionals with life experience that helps them connect with customers. We're a people-powered business, working tirelessly on behalf ofagents, clients, and employees to make life better.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Scottsdale , AZ, US

Year founded

2000

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