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Remote Insurance Utilization Review Jobs in Nevada

Coder II - Remote

Reno, NV · Remote

$18.75 - $25/hr

... and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure ... Knowledge of government and commercial insurance plans requirements. * Understands and applies ...

Showing results 41-60

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 cities in Nevada are hiring for Remote Insurance Utilization Review jobs?

Cities in Nevada with the most Remote Insurance Utilization Review job openings:

Infographic showing various Remote Insurance Utilization Review job openings in Nevada as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.

Insurance Product Manager - Property & Casualty

Superior Underwriters

Las Vegas, NV • On-site, Remote

Full-time

Posted yesterday

New


Job description

Insurance Product Manager – Property & Casualty

Position Summary: The Insurance Product Manager – Property & Casualty is responsible for developing, managing, and optimizing P&C insurance products to support profitable growth, competitive market positioning, regulatory compliance, and customer needs. This role partners closely with underwriting, actuarial, claims, sales, marketing, legal, compliance, operations, and technology teams to manage the product lifecycle from concept through launch, performance monitoring, and ongoing enhancement.

Key Responsibilities

· Develop and manage P&C insurance products throughout the full product lifecycle, including market research, product design, implementation, monitoring, and continuous improvement.

· Analyze market trends, competitive offerings, customer needs, loss experience, premium growth, profitability, and regulatory changes to identify product opportunities and risks.

· Partner with actuarial and underwriting teams to evaluate pricing, rating plans, underwriting guidelines, coverage forms, eligibility criteria, and product profitability.

· Lead product enhancement initiatives, including changes to coverage, policy language, pricing structure, forms, rules, and operational processes.

· Prepare business cases, financial analyses, product recommendations, and implementation plans for new products or product modifications.

· Coordinate with legal and compliance teams to support state filings, regulatory reviews, and adherence to applicable insurance laws and requirements.

· Collaborate with claims, operations, technology, and distribution partners to ensure products are operationally effective and aligned with customer and business expectations.

· Support go-to-market planning by partnering with sales, marketing, and training teams to develop product materials, sales tools, and internal education resources.

· Monitor product performance against key metrics, including loss ratio, retention, premium volume, rate adequacy, expense trends, customer adoption, and competitive position.

· Communicate product strategy, performance insights, and recommendations to leadership and cross-functional stakeholders.

Required Qualifications

· Bachelor’s degree in business, finance, insurance, risk management, economics, actuarial science, or a related field.

· Five or more years of experience in property and casualty insurance, product management, underwriting, product analysis, business analysis, or a related insurance role.

· Strong understanding of P&C insurance products, coverages, rating concepts, underwriting practices, policy forms, and regulatory requirements.

· Experience analyzing financial performance, loss ratios, pricing impacts, market trends, and product profitability.

· Ability to manage cross-functional projects, influence stakeholders, and drive execution across multiple business areas.

· Strong analytical, problem-solving, communication, presentation, and organizational skills.

· Proficiency with Microsoft Office applications, particularly Excel; experience with data analysis tools or reporting platforms preferred.

Preferred Qualifications

· Experience with auto, commercial lines, specialty property, or other P&C product lines.

· Experience supporting state filings, regulatory interpretation, rate changes, form changes, or product launches.

· Knowledge of actuarial pricing, reinsurance, risk segmentation, predictive modeling, or portfolio management.

· Professional insurance designation such as CPCU, AINS, ARM, API, or similar credential.

· Experience working with policy administration systems, rating engines, business intelligence tools, SQL, or data visualization platforms.

Key Competencies

· Strategic thinking and business acumen

· Financial and analytical rigor

· Knowledge of insurance risk and profitability drivers

· Cross-functional collaboration and stakeholder management

· Clear written and verbal communication

· Project management and execution discipline

· Customer, agent, and market orientation

· Adaptability in a changing regulatory and competitive environment

Work Environment

This position typically operates in a professional office, hybrid, or remote environment and requires regular collaboration with internal teams, external partners, vendors, and distribution channels. Occasional travel may be required for business meetings, industry events, or partner visits.

Equal Employment Opportunity

The company is an equal opportunity employer and considers qualified applicants without regard to legally protected characteristics. Employment decisions are based on qualifications, merit, business needs, and applicable law.