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Remote Insurance Utilization Review Jobs in Kansas

Electric Power Research Institute, Inc.

$98K - $113K/yr

Charlotte, NC, Dallas, TX, EI - Canada Home Office, Knoxville, TN, Palo Alto, CA, Remote/Home Based ... accident insurance, paid time off (flexible vacation, sick leave, and holiday pay). EPRI ...

Archera

This is a fully remote role based in the United States Key Responsibilities * Own the post-sales ... Lead Quarterly Business Reviews, presenting utilization trends, realized savings, and optimization ...

Archera

This is a fully remote role based in the United States, with East Coast candidates preferred. Key ... Lead Quarterly Business Reviews, presenting utilization trends, realized savings, and optimization ...

PNC Bank

Insurance Associate - Midland

Home, KS · On-site +1

This position may be eligible for remote work in select geographic locations, subject to approval ... Loan Review, Managing Multiple Priorities, Negotiating, Problem Solving, Process Management, Real ...

PNC Bank

Insurance Associate - Midland

Overland Park, KS · On-site +1

This position may be eligible for remote work in select geographic locations, subject to approval ... Loan Review, Managing Multiple Priorities, Negotiating, Problem Solving, Process Management, Real ...

Finite State

$99K - $100K/yr

Manages utilization across the team to balance billable engagement work, capability development ... review, and continuous learning; fosters psychological safety in a fully remote operating ...

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

Revenue Cycle Financial Analyst

The University of Kansas Health System

Lenexa, KS • Remote

Full-time

Posted 4 days ago

University Of Kansas Health System rating

7.5

Company rating: 7.5 out of 10

Based on 176 frontline employees who took The Breakroom Quiz

232nd of 887 rated healthcare providers

Job description

Position Title
Revenue Cycle Financial AnalystRemote, Southlake CampusPosition Summary / Career Interest:The Revenue Cycle Financial Analyst is responsible for identifying, tracking and resolving trends for over and under payments with EMR. This position educates external and internal customers on policies and procedures to improve process flow and decrease denials, over payments and under payments.Responsibilities and Essential Job Functions
  • Reviews Explanation Of Benefit's & Remittance Advisement's for denied claims.
  • Works with manage care organizations to identify and/or resolve claim submission requirements. Evaluates and resolves issues related to revenue cycle including charge capture, charge master, coding, claim submission or information system.
  • Prepares and maintains statistical and financial reports supporting areas of performance improvement.
  • Identifies areas of improvements utilizing financial - statistical indicators related to revenue cycle performance.
  • Reviews intradepartmental and interdepartmental processes for improvements that will decrease denials and underpaid claims that occur due to a variety of reasons related to: Authorization, Eligibility, Medical Necessity, Utilization Review, Documentation
  • Analyzes situations and makes recommendations that will achieve financial objectives related to revenue cycle.
  • Provides training to external and internal customers to educate and improve revenue cycle processes.
  • Provides input in analysis of aging trends. Submits ticket requests with Hospital Systems on systems changes to ensure billing accuracy.
  • Prepares third party appeals as appropriate.
  • Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
  • These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience
  • High School Graduate or GED.
  • Associates Degree in related field, OR Associate's Degree equivalent of 4 years of experience in claims, denials, chargemaster, coding or insurance processing.
  • 4 or more years of experience in financial reporting, processing over and under payments, claims, denials, chargemaster, coding or insurance processing.

Preferred Education and Experience
  • Bachelors Degree in related field from an accredited college or university.
  • Epic experience.

Time Type:Full timeJob Requisition ID:R-56133Important information for you to know as you apply:

  • The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion.

  • The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu.

  • Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

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What University Of Kansas Health System employees say

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About University of Kansas Health System

Sourced by ZipRecruiter

Operating within the healthcare industry, The University of Kansas Health System is a renowned medical institution located in Kansas City, KS, United States. Established in 1905, this not-for-profit health system has evolved to offer an extensive range of products and services, which spans across a variety of specialist areas such as cancer care, neurology, cardiology, and organ transplants, among others. The core mission of The University of Kansas Health System is to enhance the health and wellness of individuals and communities by providing world-class healthcare services, quality education and conducting advanced research. They are also known for their unwavering commitment to academic medicine, which sets them apart from their peers.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Kansas City, KS, US

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