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Remote Insurance Utilization Review Jobs in Ohio

Medpace, Inc.

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

Produce coding reports for team review and utilization *Stable schedule with no weekends, no work on Medpace holidays, and flexible work schedule* Qualifications * BSN and RN with applicable ...

Huntington

SBA Eligibility Review Officer III

Columbus, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... insurance, retirement savings plan, paid leave programs, paid holidays and paid time off (PTO)

Huntington

SBA Eligibility Review Officer III

Akron, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... insurance, retirement savings plan, paid leave programs, paid holidays and paid time off (PTO)

Huntington

SBA Eligibility Review Officer III

Cleveland, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance ...

Huntington

SBA Eligibility Review Officer III

Columbus, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance ...

Huntington

SBA Eligibility Review Officer III

Cleveland, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance ...

Huntington

SBA Eligibility Review Officer III

Akron, OH · On-site +1

$77K - $154K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance ...

SpecialtyRx, Inc.

Remote Pharmacist

Columbus, OH · Remote

$56.25 - $67.50/hr

Review, verify, and approve high-volume medication orders for long-term care residents. * Perform ... Group Life Insurance and Short-Term Disability. * Paid time off and paid holidays. * 401(k) with ...

SPECIALTY RX, Inc.

Remote Pharmacist

Columbus, OH · On-site +1

$58 - $60/hr

Review, verify, and approve high-volume medication orders for long-term care residents. * Perform ... Group Life Insurance and Short-Term Disability. * Paid time off and paid holidays. * 401(k) with ...

Bcbsa

Director, Trade Client Relations

New Hampshire, OH · On-site +1

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

Bcbsa

Director, Trade Client Relations

Delaware, OH · On-site +1

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

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

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 Ohio?

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

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

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

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

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

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

Cities in Ohio 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 Ohio as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.

Uptime Remote Monitoring Specialist

Cargotec

Perrysburg, OH • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Hiab is the pioneer in smart and sustainable on road load handling solutions. We believe in more than just work - we believe in making a difference for our customers to building a better tomorrow.
Say Hi! to your next challenge - explore the opportunity and apply below!
Our benefits include
  • Comprehensive benefit package including: health, vision, dental, company-paid & voluntary life insurance upon first day of employment
  • 401k program with 6% company match
  • Personal time off and company-paid holidays
  • Opportunities for career growth and competitive salary commensurate with experience
  • Tuition reimbursement for job-related continued education
  • Referral Program
  • You may also be provided with a company cell phone, laptop and/or credit card, all to be used for the purpose of conducting company business

Your mission
To perform day-to-day remote monitoring activities including monitoring incoming alerts, performing diagnostics and notifying the appropriate stakeholders and/or taking appropriate actions to provide best in class customer service. Supporting the development and improvement of remote monitoring services.
Key responsibilities
  • Perform remote monitoring of equipment alerts for customer equipment fleets, and perform remote diagnostics of errors
  • Work with technical support & field service operations teams to provide a seamless customer experience from recommendation to resolution. This includes providing technical support/field engineering teams an overall view of the customer's fleet under an Uptime Remote Monitoring Agreement
  • Gather knowledge and information from the operations and technical support teams and help them to be successful with new digital ways of working and innovative remote maintenance
  • Provide valuable input to the operations and technical support teams to create action item recommendations to improve the performance of equipment
  • Provide input and learnings to the data science team responsible for creating and maintaining predictive algorithms
  • Help customers and partners to reduce owning and operating costs and improve equipment availability/utilization. This may include fact-based repair or operational recommendations that enable proactive maintenance, repair, and application management for the customer

What we are looking for
  • Bachelor's degree in relevant field or equivalent experience in mechanical, electrical, or sustainability engineering or technical troubleshooting
  • +3 years of experience with remote monitoring or troubleshooting electrical and mechanical faults, preferably in a heavy equipment or trucking environment.
  • Understanding of reading and interpreting mechanical, hydraulic and electrical schematics
  • Proficient with interpreting results from complex technical analyses and present results in a form that is understood and actionable by operations, product, or marketing stakeholders
  • Experience in working closely with partners and customers with a focus on adding value to their business by providing solutions
  • Limited travel <10%

What we offer
As a part of our Employees First culture, we offer opportunities to grow within a dynamic environment that values flexibility and your well-being. We strive to make things easier, empower you to succeed, and strive for excellence in a positive and inclusive environment.
Ready to apply?
If you are excited about this opportunity, please submit your Resume/CV today for consideration!
HIAB USA is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, veteran status, genetic information, or any other legally protected characteristic. All employment decisions, including recruitment, hiring, and training, are based on merit, qualifications, and business needs.
We Are HiabHiab (Nasdaq Helsinki: HIAB) is a leading provider of smart and sustainable on road load-handling solutions, committed to delivering the best customer experience every day with the most engaged people and partners. As the industry pioneer, Hiab continues to make on road load-handling smarter, safer and more sustainable to build a better tomorrow.
www.hiabgroup.com

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