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Remote Insurance Utilization Review Jobs in Texas

SUN Behavioral Houston

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

... insurance company/third-party payor. Able to work through and accept referrals through various ... Demonstrates understanding of utilization review process to include treatment criteria and ...

Wings of the Future, NFP

Clinical Supervisor

Dallas, TX · Remote

Familiarity with insurance documentation, medical-necessity requirements, utilization review, and ... Remote-Work and Compliance Expectations This position must be performed from a private ...

Posted today

WNS Global Services

Sr Nurse - Clin. Education

Houston, TX · On-site +1

$80K - $95K/yr

... Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain ... pertaining to Utilization Review process, clinical rules/guidelines, client/module/modality ...

Corvel

Payment Integrity Analyst II

Fort Worth, TX · Remote

$66K - $101K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Reviews, analyzes, and ... Prospective, concurrent and retrospective utilization review * 1+ years healthcare revenue cycle ...

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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 Texas?

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

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

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

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

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

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

Cities in Texas 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 Texas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Physician Hospitalist - Competitive Salary

CorroHealth

Dallas, TX • Remote

Other

Re-posted 20 days ago

CorroHealth rating

8.1

Company rating: 8.1 out of 10

Based on 27 frontline employees who took The Breakroom Quiz

108th of 495 rated business services

Job description

**FOR THOSE WITH SERIOUS INTEREST, PLEASE APPLY DIRECTLY ON CORROHEATH'S CAREER PAGE** THANK YOU. 
As a Medical Director, Concurrent Review for CorroHealth, you’ll have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to CorroHealth’s client hospitals. You will perform concurrent clinical case reviews and provide recommendations that focus on establishing the appropriate admission status. CorroHealth offers a career path that allows you to continue using your clinical knowledge and drive value to hospitals while providing you with a predictable schedule. This opportunity allows for the work/life balance you desire while expanding your knowledge base in Utilization Review. 

The Impact You Will Have:  

 CorroHealth is led by like-minded clinicians who share the same innate calling to help. Hospitals nationwide have recently struggled with managing complex and unforeseen challenges such as global pandemics, complex regulatory updates, and downstream policy changes set forth by Medicare and private payer organizations – resulting in financial difficulty.  CorroHealth physicians lead challenging and rewarding careers by providing our hospital clients with guidance to improve compliance and ensure appropriate payment for the care delivered. The impact of your role will allow attending physicians to focus on what is most important, providing dedicated care to the patients they serve.   

 Your Schedule: 

Training (The First 4 Weeks): 

  • Fully remote, synchronous training will occur Monday-Friday 9A-5P ET, which also includes a one-hour break 

After Completion of Training: 

You will be required to work a minimum set 30-hour per week schedule. Potential schedules are as follows:

  • Fridays (7 hours), Sat (8 hours), Sun (8 hours), Mon (7 hours)

  • Friday, Sat, Sun (10 hours each)

  • Sat, Sun Mon (10 hours each)

Working at CorroHealth: 

  • All necessary hardware and software is provisioned to each of our Medical Directors   

  • You have the ability to work remotely in a comfortable environment 


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