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Remote Insurance Utilization Review Jobs in Kentucky

Lifepoint Health

Appeals Coordinator- Remote

Louisville, KY · Remote

$20.25 - $25/hr

Verify the information needed by the insurance plan for an appeal, where to submit the appeal, and ... Previous utilization review experience in a psychiatric healthcare facility preferred * Computer ...

Lifepoint Health

Appeals Coordinator- Remote

Louisville, KY · On-site +1

$20.25 - $25/hr

Verify the information needed by the insurance plan for an appeal, where to submit the appeal, and ... Previous utilization review experience in a psychiatric healthcare facility preferred * Computer ...

PharMerica

Claims Specialist / Remote

Louisville, KY · Remote

Company-Paid Disability Insurance * Tuition Assistance & Reimbursement * Employee Discount Program ... Reviews and works to convert billing exception reports to ensure claims are billed to accurate ...

Harris

(Remote) Implementation Consultant

Canada, KY · Remote

Ability to review error logs & debugging skills * Adept at writing SQL queries * Familiarity with S ... Excellent fringe benefits including Health, Dental, Vision and Life and Disability insurance

Harris

(Remote) Implementation Consultant

Canada, KY · Remote

Ability to review error logs & debugging skills * Adept at writing SQL queries * Familiarity with S ... Excellent fringe benefits including Health, Dental, Vision and Life and Disability insurance

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

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 Kentucky? For Remote Insurance Utilization Review jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Kentucky look for? The top searched job categories for Remote Insurance Utilization Review jobs in Kentucky are:
What cities in Kentucky are hiring for Remote Insurance Utilization Review jobs? Cities in Kentucky with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you
Remote Insurance Broker

Remote Insurance Broker

Spieldenner Financial Group

Hopkinsville, KY • On-site, Remote

$10K - $20K/wk

Contractor

Posted 11 days ago

Job description

Spieldenner Financial Group is expanding and looking for driven, self-starting individuals who want to build a meaningful career while helping families protect what matters most-their income.
This opportunity is ideal for individuals who value flexibility, mentorship, and a system designed to support long-term success. Whether you're experienced or new to the industry, we provide the training and guidance needed to compete at a high level.
What You'll Do
Connect with Clients (6-8 hrs/week)
Reach out to individuals who have already expressed interest in coverage and schedule appointments to review their needs.
Prepare Personalized Solutions (4-5 hrs/week)
Analyze client information to tailor mortgage protection options that align with their financial goals and family needs.
Meet & Advise (2 days/week)
Conduct virtual or in-person consultations (your choice) to educate clients, walk them through coverage options, and assist with applications.
Manage Follow-Up (2 hrs/week)
Coordinate with insurance carriers and support clients through the underwriting process to ensure a smooth experience.
Who We're Looking For
  • Self-motivated and coachable individuals
  • Strong work ethic and desire to grow
  • Comfortable working independently
  • Positive mindset and willingness to learn

No prior experience required-we focus on attitude, discipline, and commitment.
Flexible Work Options
We believe success shouldn't come at the expense of your personal life. Choose the schedule that fits your goals:
  • Spare Time (4-8 hrs/week): $500-$2,000/month potential*
  • Part-Time (8-25 hrs/week): $2,000-$5,000/month potential*
  • Full-Time (25-50 hrs/week): $10,000-$20,000+/month potential*
Why Spieldenner Financial Group?
  • Comprehensive training and ongoing mentorship
  • Proven systems and lead support
  • Fully remote, flexible work environment
  • Growth-focused culture with advancement opportunities

If you're looking for a career where your effort directly impacts your income and your schedule, we encourage you to apply and learn more.
Important Disclaimer:
No agent's success, earnings, or production results should be viewed as typical, average, or expected. Not all agents achieve the same or similar results, and no particular results are guaranteed. Your level of success will depend on factors including your effort, ability to follow training and systems, engagement with leads, and client needs in your area.

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