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Remote Insurance Utilization Review Jobs in Cleveland, OH

Drips

Senior Product Manager (Remote)

Cleveland, OH · Remote

$129K - $170K/yr

You can write a PRD in the morning, jump on a customer call in the afternoon, and review an API ... Experience building product for enterprise healthcare, particularly with insurance payers, and ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

System One

Income Verification Specialist

Cleveland, OH · Remote

$23.50/hr

Remote Hours: 8a-5p, M-F EST Job Summary The Housing Specialist supports low-income families and ... Conduct annual and interim eligibility reviews, rent calculations, and recertifications for HCV ...

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Showing results 21-40

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Cleveland, OH

Remote Insurance Utilization Review information

See Cleveland, OH salary details

$20

$41

$66

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

As of Aug 23, 2026, the average hourly pay for remote insurance utilization review in Cleveland, OH is $41.01, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.12 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 Cleveland, OH?

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

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

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

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

Cities near Cleveland, OH 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 Cleveland, OH as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $85,293 per year, or $41 per hour.

Patient Billing Representative

Five Star Solutions

Cleveland, OH • On-site, Remote

$14/hr

Full-time

Posted 4 days ago

Job description

Join us as a Patient Billing Specialist, where you'll support patients with payment processing, billing education, insurance verification, and claims-related inquiries. This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies. Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND, OH, OK, PA, SC, SD, TX, TN, UT, VA, WV, WI, WY
Qualifications
  • Customer service or call center experience required.
  • Healthcare billing, insurance, or claims experience strongly preferred.
  • Payment processing or financial transaction experience preferred.
  • High school diploma or GED required; additional billing or healthcare education a plus.
  • Technical proficiency with EMR systems and standard computer applications.
  • Ability to work independently in a remote or virtual environment.
  • Must be able to speak, read, write, and understand English.
  • Background check required in accordance with applicable laws.

Essential Functions
These functions emphasize patient advocacy, analytical billing expertise, regulatory awareness, and high-quality service delivery.
Patient Payment & Account Support
  • Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
  • Create, update, and maintain payment plans following established guidelines.
  • Ensure transaction accuracy, proper documentation, and data integrity.

Billing, Insurance & Claims Support
  • Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
  • Verify, audit, and update insurance information for completeness and accuracy.
  • Add or update insurance data within the EMR and resubmit pending or corrected claims.
  • Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
  • Identify discrepancies and coordinate with internal teams to resolve billing-related issues.

Problem Resolution & Patient Education
  • Research account history to determine the root cause of billing or payment concerns.
  • Recommend appropriate resolutions and next steps in alignment with Privia policies.
  • Maintain professionalism and empathy during complex or sensitive financial discussions.

Resource & System Utilization
  • Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
  • Navigate multiple systems simultaneously while assisting patients.
  • Adhere to all documentation, privacy, and security requirements.

Reliability & Continuous Learning
  • Maintain schedule adherence and consistent availability during assigned hours.
  • Complete all required Privia and client-mandated training.
  • Participate in ongoing uptraining and cross-training initiatives.

Ethical & Compliant Conduct
  • Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
  • Demonstrate professionalism, accountability, and patient-centered service in all interactions.

Requirements
  • Strong verbal and written communication skills.
  • Analytical problem-solving abilities and high attention to detail.
  • Solid understanding of healthcare billing and insurance concepts.
  • Ability to clearly explain complex billing information in patient-friendly language.
  • Comfort working across multiple systems and tools simultaneously.
  • Organized, self-motivated, and collaborative approach to work.

Pay and Benefits
Starting pay - $14/hr plus shift differential(extra $1/hr nights & wkds)
Working hours between - 9:00am-6:00pm (EST) ; Work Days - M-F
Paid Training - typically 2 weeks in length from 9:00am-6:00pm Mon-Fri (EST)
Status - Full Time 40 hours, Benefit eligible 1st of month after 60 days
$14 - $14 an hour
The above statements are intended to describe the general nature and level of work and are not intended to be an exhaustive list of all responsibilities, duties, and skills required of the job
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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