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Remote Insurance Utilization Review Jobs in Michigan

CSAA

Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements ... CSAA Insurance Group is an equal opportunity employer. #li-ml1 . The national average salary range ...

CSAA

Job Title Commercial Insurance Analytics Consultant - Remote Requisition Number R7735 Commercial ... Reviews and guides work performed by less senior analysts , delegating components of analysis ...

BetterHelp

Psychiatrist - (Remote)

Detroit, MI · Remote

$125 - $171/hr

At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... utilization of add-on codes (such as 90833) when clinically appropriate and properly documented

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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 the most commonly searched types of Insurance Utilization Review jobs in Michigan? The most popular types of Insurance Utilization Review jobs in Michigan are:
What are popular job titles related to Remote Insurance Utilization Review jobs in Michigan? For Remote Insurance Utilization Review jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Michigan look for? The top searched job categories for Remote Insurance Utilization Review jobs in Michigan are:
What cities in Michigan are hiring for Remote Insurance Utilization Review jobs? Cities in Michigan with the most Remote Insurance Utilization Review job openings:
Remote Insurance Utilization Review jobs near you

Modern Remote Life Insurance Agent - No Cold Calling

AO Garcia Agency

Grand Rapids, MI • Remote

Other

Posted 9 days ago

Job description

Licensed Life Insurance Agents Only

Join a fast-growing, tech-driven insurance organization looking for experienced agents who want a smarter way to build their business. The high-tech system delivers warm, qualified leads - so you can spend your time closing, not chasing.

Perks Include:
100% remote - work from anywhere
No cold calling, ever
High-quality leads provided and called for you
Competitive compensation with real income potential
Fast-track leadership opportunities
Modern CRM, automation tools, and training

Requirements:
Active life insurance license
Strong communication and follow-up skills
Coachable and self-motivated

*All interviews will be conducted via Zoom video conferencing
(Global Elite Empire Consultants is a third-party recruiter, not an insurance agency)
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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