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Remote Insurance Utilization Review Jobs in Chicago, IL

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

... Insurance Portability and Accountability Act (HIPAA) standards * Understand and comply with ... Board Certification by the American Board of Quality Assurance and Utilization Review Physicians ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Chicago, IL

Remote Insurance Utilization Review information

See Chicago, IL salary details

$22

$43

$71

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

As of Aug 9, 2026, the average hourly pay for remote insurance utilization review in Chicago, IL is $43.56, according to ZipRecruiter salary data. Most workers in this role earn between $34.42 and $50.00 per hour, depending on experience, location, and employer.

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.

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 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.
What are the most commonly searched types of Insurance Utilization Review jobs in Chicago, IL? The most popular types of Insurance Utilization Review jobs in Chicago, IL are:
What are popular job titles related to Remote Insurance Utilization Review jobs in Chicago, IL? For Remote Insurance Utilization Review jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Chicago, IL look for? The top searched job categories for Remote Insurance Utilization Review jobs in Chicago, IL are:
What cities near Chicago, IL are hiring for Remote Insurance Utilization Review jobs? Cities near Chicago, IL 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 Chicago, IL as of August 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $90,598 per year, or $43.6 per hour.

Utilization Review Nurse

Silver Cross Hospital

New Lenox, IL • On-site, Remote

$34.73 - $45.15/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Silver Cross Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

551st of 1,055 rated hospitals

Job description

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated.
Position Summary: Performs medical record review for severity of illness and intensity of service; liaison function with external review agencies to ensure compliance with regulations affecting financial reimbursement; identifies variance from established pathways
Essential Duties and Responsibilities:
  • Collects information from clinical medical record for severity of illness and intensity of service and documents such in clinical database
  • Monitors all levels of care for appropriateness and communicates variance; evaluates plan of care to ensure it is based on accepted standards
  • Provides information to external review organizations, documents pertinent communications
  • Refers to designated physician advisor those patients not meeting criteria as well as quality of care concerns
  • Maintains knowledge and incorporates current standards into practice

Required Qualifications: Knowledge of clinical norms; excellent communication skills; critical thinking skills; organized and efficient time management skills
Education and Training:
  • Nurse, Registered (RN) licensure
  • BSN preferred. 2-5 years previous Utilization Review experience preferred.
  • Current CPR
  • Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred

Work Shift Details:
Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site requirement for meetings and mandatory training
Department:
CONTINUUM OF CARE
Benefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:
• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement
Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
The expected pay for this position is listed below:
$34.73 - $45.15

What Silver Cross Hospital employees say

Pay

Benefits

Hours and flexibility

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About Silver Cross Hospital

Sourced by ZipRecruiter

At Silver Cross, we pride ourselves on delivering unrivaled care to every patient, every time. As a result, our focus on safety, quality and patient experience has earned us numerous national awards over the years. As the needs of our community have grown, so has Silver Cross—in both size and stature. Our many healthcare services rapidly expanded, evolved and increased in complexity. To serve you and your loved ones even better than before, we've proudly partnered with many of Chicago's leading academic medical centers, bringing extraordinarily advanced care close to home.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

New Lenox, IL, US

Year founded

1895

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