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Remote Insurance Utilization Review Jobs in Chicago, IL

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 ...

New

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 ...

New

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 ...

New

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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 Jul 20, 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 are remote insurance utilization review jobs?

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 are the key skills and qualifications needed to thrive as a Remote Insurance Utilization Review Specialist, and why are they important?

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
ABA Utilization Review (UR) Specialist

ABA Utilization Review (UR) Specialist

Spectrum Billing Solutions

Skokie, IL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 22 days ago

Job description

​
Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.
We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist external clients in understanding payer requirements for authorizations.
  • Participate in team meetings.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
  • Flexible work environment 
  • Competitive Salary
  • A close-knit team of talented and skilled individuals.
  • Growth opportunities 
  • Benefits – Medical, Dental, Vision
  • Flexible Paid Time Off
  • 401K with Company match
  • Supplemental Benefits
Qualifications:
  • 3-5 years of related ABA and/or Behavioral Health experience.
  • Bachelor’s or master’s degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services.
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