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Remote Insurance Utilization Review Jobs in Cincinnati, OH

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 ...

Although the position will be remote, there might be some occasional travel to ERP Suites ... Review OCI consumption reports, billing dashboards, and cost optimization opportunities. * Conduct ...

Although the position will be remote, there might be some occasional travel to ERP Suites ... Monthly Activities: • Review OCI consumption reports, billing dashboards, and cost optimization ...

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Remote Insurance Utilization Review information

See Cincinnati, OH salary details

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$66

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

As of Aug 20, 2026, the average hourly pay for remote insurance utilization review in Cincinnati, OH is $40.57, according to ZipRecruiter salary data. Most workers in this role earn between $32.07 and $46.59 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 the most commonly searched types of Insurance Utilization Review jobs in Cincinnati, OH?

The most popular types of Insurance Utilization Review jobs in Cincinnati, OH are:

What are popular job titles related to Remote Insurance Utilization Review jobs in Cincinnati, OH?

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

What job categories do people searching Remote Insurance Utilization Review jobs in Cincinnati, OH look for?

The top searched job categories for Remote Insurance Utilization Review jobs in Cincinnati, OH are:

What cities near Cincinnati, OH are hiring for Remote Insurance Utilization Review jobs?

Cities near Cincinnati, OH with the most Remote Insurance Utilization Review job openings:

Infographic showing various Remote Insurance Utilization Review job openings in Cincinnati, OH as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $84,382 per year, or $40.6 per hour.

Clinical Data Coder

Medpace, Inc.

Cincinnati, OH • On-site, Remote

$18 - $22.75/hr

Full-time

Medical, Retirement, PTO

Re-posted 22 hours ago


Medpace rating

8.6

Company rating: 8.6 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

13th of 74 rated research


Job description

Job Summary

Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This position will work on a team to accomplish tasks and projects that are instrumental to the company's success. If you want an exciting career where you use your previous coding, pharmacy, or nursing expertise and can develop and grow your career even further, then this is the opportunity for you!

Responsibilities
  • Perform accurate coding of medical terms and medications utilizing industry-wide standards as well as company standards;
  • Coordinate the assignment of appropriate dictionaries for meeting study requirements
  • Develop and maintain coding guidelines;
  • Issue queries on adverse events, medications, and medical history terms to ensure high quality coding;
  • Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet needs of the study; and
  • 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 experience is required, or more advanced clinical degree (including PharmD) is accepted;
  • Strong critical thinking, organizational, and multi-tasking skills required;
  • Experience with using MedDRA and WHO Drug dictionaries preferred; and
  • Experience working with clinical trials or within the pharmaceutical environment is preferred.

TRAVEL: None

Medpace Overview

Medpace is a full-service clinical contract research organization (CRO) providing phase l-lV clinical development services to the biotechnology, pharmaceutical, and medical device industries. Our mission is to accelerate the global development of safe and effective medical therapeutics through the advancement of clinical research. We leverage in-country regulatory and therapeutic expertise across all major therapeutic areas including oncology, cardiology, metabolic, endocrinology, central nervous system, and anti-viral and anti-infective. Headquartered in Cincinnati, Ohio, we employ more than 6,500 people across 40+ countries.

Why Medpace?

When you join Medpace, you become part of an innovative team that brings cutting-edge therapies to market while building a meaningful and rewarding career focused on scientific excellence and improving patient outcomes around the world through continuous learning and cross-functional collaboration.

Purpose-Driven Work

    • Work alongside physicians, scientists, and industry-leading experts committed to advancing the global development of medical therapeutics through clinical research excellence

Collaborative Culture

    • Contribute to an interactive team environment that empowers decision making, creative thinking, and continuous learning through open communication and mutual trust.
    • Leadership throughout Medpace is both accessible and approachable

Continuous Growth & Development

    • Office based environment with on-site mentors
    • Defined career paths with clear advancement opportunities
    • Industry renowned onboarding and training programs designed to accelerate professional development
    • Ongoing training and continuous learning opportunities throughout your career
    • An environment that encourages employees to influence change, contribute ideas, and grow quickly

Other Employee Benefits

    • Competitive compensation programs that recognize and reward performance
    • Comprehensive health, wellness, retirement, and PTO benefits
    • Office based culture with occasional WFH that provides flexibility for eligible positions after training
    • Company-sponsored social events and intramural sports

Cincinnati Headquarters Experience

    • A modern corporate campus designed to support collaboration and productivity
    • Multiple on-site dining options in the heart of Madison Square
    • Free on-site parking
    • Convenient access to on-site 24-7 fitness and wellness facilities

What to Expect Next

A Medpace team member will review your application and if your profile matches our current needs, you will be contacted for an interview. While we review all applications carefully, we are unable to respond to every applicant, and only candidates selected for interviews will be contacted.

Employment Type: OTHER

What Medpace employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Medpace logo

About Medpace

Sourced by ZipRecruiter

Medpace is a globally recognized clinicial contract research organization (CRO) based in Cincinnati, OH, in the United States. Established in 1992, it operates in the healthcare sector, providing scientifically-driven outsourcing solutions for the development of drugs and medical devices. It offers comprehensive services like full-service clinical development services, regulatory affairs management, clinical pharmacology, data management, statistical analysis, and medical writing. By applying a scientifically-driven, therapeutically-focused, and patient-centric approach, Medpace's mission is to accelerate the global development of safe and effective medical therapies.

Industry

Medical equipment and supplies manufacturing

Company size

1,001 - 5,000 Employees

Headquarters location

Cincinnati, OH, US

Year founded

1992