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Remote Insurance Utilization Review Jobs in Cape May, NJ

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Cape May, NJ

Remote Insurance Utilization Review information

See Cape May, NJ salary details

$21

$42

$69

How much do remote insurance utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for remote insurance utilization review in Cape May, NJ is $42.36, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $48.65 per hour, depending on experience, location, and employer.

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 popular job titles related to Remote Insurance Utilization Review jobs in Cape May, NJ?

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

What cities near Cape May, NJ are hiring for Remote Insurance Utilization Review jobs?

Cities near Cape May, NJ with the most Remote Insurance Utilization Review job openings:

Remote Insurance Utilization Review jobs near you

Account Manager - State Farm Agent Team Member

Catie Walther - State Farm Agent

Lewes, DE • Remote

$68K - $80K/yr

Full-time

Medical, PTO

Re-posted 24 days ago

Job description

Benefits:
  • License reimbursement
  • Team building events
  • Bonus based on performance
  • Competitive salary
  • Flexible schedule
  • Health insurance
  • Opportunity for advancement
  • Paid time off
  • Training & development

ROLE DESCRIPTION:
As Account Manager - State Farm Agent Team Member for Catie Walther - State Farm Agent, you are vital to our daily business operations and customers’ success. You grow our agency through meaningful customer relations and acting as a liaison between customer needs and agency departments. You improve the lives of our customers by proactively marketing relevant products and services.
Grow your career as you better your community. As an attentive, sociable, and sales-minded professional, we are eager to have you on our team.
RESPONSIBILITIES:
  • Develop and maintain customer relationships to drive retention and growth.
  • Conduct policy reviews and provide recommendations to customers.
  • Oversee the resolution of complex customer issues.
  • Use your knowledge of our insurance products to recommend, explain and sell policies to both cold and warm leads.
QUALIFICATIONS:
  • Experience in insurance sales or account management preferred.
  • Leadership and interpersonal skills.
  • Proven track record of meeting sales targets.
  • Willingness to engage in sales conversations.

This is a remote position.