ZipRecruiter

Log In

2

Remote Insurance Utilization Review Jobs in Detroit, MI

Huntington

Credit Review Specialist - Commercial

Detroit, MI · On-site +1

$63K - $124K/yr

Remote roles will also have the opportunity to come together in our offices for moments that matter ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance ...

Integra Partners

Medical Coding Specialist

Troy, MI · Remote

$65K - $65K/yr

The Medical Coding Specialist provides coding expertise to support Utilization Management ... Quality Review • Perform thorough self review of work prior to submission to ensure accuracy ...

next page

Showing results 1-20

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Detroit, MI

Remote Insurance Utilization Review information

See Detroit, MI salary details

$21

$41

$68

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

As of Jul 26, 2026, the average hourly pay for remote insurance utilization review in Detroit, MI is $41.86, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 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 Detroit, MI? The most popular types of Insurance Utilization Review jobs in Detroit, MI are:
What are popular job titles related to Remote Insurance Utilization Review jobs in Detroit, MI? For Remote Insurance Utilization Review jobs in Detroit, MI, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Detroit, MI look for? The top searched job categories for Remote Insurance Utilization Review jobs in Detroit, MI are:
What cities near Detroit, MI are hiring for Remote Insurance Utilization Review jobs? Cities near Detroit, MI 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 Detroit, MI as of July 2026, with employment types broken down into 83% Full Time, and 17% Temporary. Highlights an 100% Remote job distribution, with an average salary of $87,064 per year, or $41.9 per hour.
Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Corporate Services

Troy, MI • Remote

Other

Posted 3 hours ago

Job description

In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient.  You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.

Hours are Monday - Friday from 830am until 5pm with no weekends

EDUCATION AND EXPERIENCE: 

  • RHIT, RHIA, or related coding certification required. 
  • Minimum 3-5 years of clinical experience preferred. 
  • Previous utilization management or case management experience preferred. 

CERTIFICATIONS/LICENSURES REQUIRED:

  •  RHIT, RHIA, or related coding certification required.
Additional Information
  • Organization: Corporate Services
  • Department: Central Utilization Mgt
  • Shift: Day Job
  • Union Code: Not Applicable

Apply