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Remote Insurance Utilization Review Jobs in New York

HURC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

Hurc LLC

Physician Advisor

Short Hills, NJ · Remote

Support utilization review and case management teams with complex clinical decision-making * Ensure ... Experience in a remote or consulting healthcare environment Skills & Competencies * Physician-to ...

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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 the most commonly searched types of Insurance Utilization Review jobs in New York?

The most popular types of Insurance Utilization Review jobs in New York are:

What are popular job titles related to Remote Insurance Utilization Review jobs in New York?

For Remote Insurance Utilization Review jobs in New York, the most frequently searched job titles are:

What job categories do people searching Remote Insurance Utilization Review jobs in New York look for?

The top searched job categories for Remote Insurance Utilization Review jobs in New York are:

What cities in New York are hiring for Remote Insurance Utilization Review jobs?

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

Remote Insurance Utilization Review jobs near you

Remote Insurance Sales Representative

The Carballo Financial Group

Fort Lee, NJ • Remote

$78K - $87K/yr

Full-time

Medical, Retirement, PTO

Re-posted 25 days ago

Job description

Why Now Allstate & The Carballo Agencies

Allstate has recently repriced in New Jersey, and that matters. We're writing new business at competitive rates. If you know how to sell, you're stepping into a market working in your favor.

What You'll Earn

Base salary of $40,000$45,000 depending on experience, plus uncapped commission averaging $1,800$3,500/month. First-year producers here have earned $78,000$87,000, and because commission is uncapped, strong producers go higher. We invest up to $2,500/month in marketing per producer, so you're getting fresh, targeted prospects and building pipeline with real lead flow not starting from zero.


What You'll Do

You'll work remotely, speaking with customers about auto, home, renters, and related products. That means running consultations, presenting options clearly, quoting, closing, and binding all by phone and digital tools. Structured process, real lead flow, no door-knocking.


Requirements

Active P&C license required(Personal Lines will be considered)

Minimum 2 years of sales experience

Located in the Eastern time zone

Private, dedicated workspace for phone and video work with staff and clients

Stable internet connection

Authorized to work in the U.S.

Equipment provided by The Carballo Agencies.

Benefits




Uncapped commission on top of base

Up to $2,500/month in marketing support per producer fresh, targeted prospects

Medical stipend/or Medical Contribution

Supplemental retirement plan

Paid time off and paid holidays

Fully remote


Frequently Asked Questions

Is this role fully remote? Yes 100% remote. You must be based in the Eastern time zone.

Is this "work from anywhere"? No. This is a structured, full-time remote position, not a laptop-and-travel setup. You'll need a dedicated, private workspace and stable internet. We provide equipment; you bring the focus and the commitment.

What does commission look like? It averages $1,800$3,500/month on top of base, and it's uncapped.

What about marketing support? We invest up to $2,500/month per producer to bring you fresh, targeted prospects and help you build pipeline. You're not out there alone.


Do I need prior Allstate experience? No. You need your P&C license, at least 2 years in sales, and the ability to close.

What's the hiring process? Fast. Resume review, a short assessment, a quick 10-minute Zoom, and we go from there.

Ready to talk?


Apply, and I'll reach out to schedule a quick 10-minute video conference to see if we're aligned. Reply with a day and time that work, along with a personal email so I can send the link.

Jason Carballo, The Carballo Agencies Allstate Insurance


Benefits

Annual Base Salary + Commission + Bonus Opportunities

Paid Time Off (PTO)

Work from Home

Health Insurance

Hands on Training

Mon-Fri Schedule

Retirement Plan

Career Growth Opportunities

Professional Work Environment

Evenings Off

Uncapped Commission

Monthly Team Bonuses


Responsibilities
  • Connect with potential clients to understand their insurance needs and financial aspirations.
  • Offer personalized guidance and recommend suitable insurance products.
  • Build and maintain strong, trusting relationships with clients through clear and empathetic communication.
  • Manage your sales pipeline effectively, from initial contact to closing the sale.
  • Stay informed about the latest insurance products and industry trends.
  • Collaborate with the team to share insights and best practices.

Requirements
  • Proven experience in insurance sales
  • Excellent communication and interpersonal skills, with the ability to connect authentically with clients.
  • A proactive and self-motivated approach to managing your workload.
  • Proficiency with CRM systems and virtual communication tools.
  • A strong desire to help clients achieve their financial security goals.
  • Strong telephone and lead manangent experience

.