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Remote Insurance Utilization Review Jobs in Houston, TX

Insurance Representative Company: AO (American Income Division) Work Arrangement: 100% Remote (U.S ... Review existing policies and recommend updates when appropriate * Respond professionally to client ...

New

Remote Intake Coordinator

Houston, TX · On-site +1

$17.25 - $23.50/hr

... insurance company/third-party payor. Able to work through and accept referrals through various ... Demonstrates understanding of utilization review process to include treatment criteria and ...

Sr Nurse - Clin. Education

Houston, TX · On-site +1

$80K - $95K/yr

... Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain ... pertaining to Utilization Review process, clinical rules/guidelines, client/module/modality ...

Insurance Specialist

Houston, TX · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Reviews the insurance verification and completes the authorization process within established time ...

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Reviews the insurance verification and completes the authorization process within established time ...

Care Manager - Remote

Houston, TX · Remote

$60K - $77K/yr

Create, review, and update patient-centered care plans based on physical, mental, cognitive ... utilization and hospital readmissions. Coordinate care with patients, caregivers, primary care ...

Insurance Verification Coordinator (Remote) 100% Remote Pay: $17.50 - $26.00 per hour Schedule ... Review and document copays, deductibles, coinsurance, out-of-pocket amounts, and authorization ...

Be Seen First

In Office position is preferable but we are able to remote across the country. Responsibilities ... Conduct policy reviews, customer retention activities, and cross-sell conversations. * Draft and ...

Showing results 21-40

Remote Insurance Utilization Review information

See Houston, TX salary details

$20

$40

$65

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

As of Aug 10, 2026, the average hourly pay for remote insurance utilization review in Houston, TX is $40.38, according to ZipRecruiter salary data. Most workers in this role earn between $31.92 and $46.39 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 cities near Houston, TX are hiring for Remote Insurance Utilization Review jobs? Cities near Houston, TX with the most Remote Insurance Utilization Review job openings:
Infographic showing various Remote Insurance Utilization Review job openings in Houston, TX as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% Remote job distribution, with an average salary of $83,986 per year, or $40.4 per hour.

Collector Insurance Specialist - Remote

Philadelphia Insurance Companies

Houston, TX • On-site, Remote

$55K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago


Philadelphia Insurance Companies rating

8.9

Company rating: 8.9 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

48th of 304 rated insurance


Job description

Marketing Statement:

Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.

Join the team at American Collectors Insurance, proudly part of PHLY, where passion meets protection!

We are looking for licensed insurance sales and service professionals to join our remote call center team as Collector Car Insurance Specialists.

This is a virtual call center position, but our office is located in Mt Laurel, NJ and this role may be performed in-office, hybrid or fully remote from anywhere in the continental US.

Collector Car Insurance Specialists and Associate Collector Car Insurance Specialists at American Collectors Insurance work directly with policy holders, agents and brokers through our virtual call center to support new and existing policies. They handle both inbound and outbound calls, respond to email inquiries, provide solutions, and document issues in CRM, while multitasking in a fast-paced, customer-facing environment. We expect our team to provide excellent customer service while maintaining our underwriting integrity, whether they are binding a new policy or servicing an existing customer.

We are looking for individuals with a growth mindset, as this role has a clear progression plan. You will begin in a service-focused position and with experience, training and stronger product knowledge, may transition into a sales-focused role.

To be considered for this role, you must have an active Property & Casualty or Personal Lines insurance license, prior insurance experience in both sales and service, a passion for client interaction, strong problem-solving skills, and the ability to thrive in a fast-paced environment.

In this role you will:

  • Communicate directly with policy holders, agents and brokers on new and existing business via phone and email
  • Maintain our underwriting integrity by adhering to company underwriting standards and philosophy
  • Conduct risk analysis
  • Determine eligibility
  • Quote and bind new business
  • Make changes to in-force policies
  • Answer back-to-back inbound calls
  • Make outbound follow-up calls and respond promptly customer inquiries
  • Establish relationships and follow up with customers
  • Provide prompt, accurate and friendly customer service

About the company: American Collectors Insurance, part of PHLY, has been specializing in collector car insurance policies since 1976. We offer peace of mind through industry-leading insurance protection for appreciating collector vehicles and collectible items that have special historical, sentimental, or financial value.

American Collectors Insurance collaborates with Condon Skelly, Heacock Classic and JC Taylor Insurance, forming a powerhouse collective within the realm of collectibles and collector car insurance. Our mission transcends insurance; we are on a journey to "Embrace, Protect, and Expand the Collector Community." This is more than a motto; it's a commitment to fostering a vibrant community of enthusiasts, historians, and guardians of prized possessions.

Join us at American Collectors Insurance, where every day is an opportunity to contribute to a rich legacy, protect cherished memories, and be part of a community that values passion and excellence. Embrace the extraordinary - apply now!

Compensation: $50-55k/yr - depending on experience level, overtime eligible (not required)

Benefits: health insurance (medical, dental, vision), flexible spending & health savings accounts, life insurance, retirement plan, paid time off, overtime availability, employee referral program

Weekly Schedule: 40-hour work week, Monday to Friday with rotating Saturday (about 1 every 4 weeks)

Responsibilities:

  • Demonstrate high level of responsiveness and focus on providing our customers and brokers with a superior level of service
    • Process/close the sales on new business
    • Perform changes to in-force policies
    • Identify coverage comparison, program highlights and values, and effectively communicate to close the sale
    • Complete necessary documentation quickly and efficiently
    • Follow and adhere to underwriting compliance and service standards
  • Conduct risk analysis and evaluate underwriting quality of applicants
    • Evaluate application factors/details to appropriately match premium to underwriting risk
  • Expected to be on phones throughout the day handling inbound calls and outbound follow-up calls
  • Create and maintain relationships with customers and brokers
    • Build trust and credibility quickly
  • Meet all production goals
  • Escalate complex risks to Senior Specialists to review/evaluate

Qualifications:

  • High school diploma or equivalent
  • Prior insurance sales experience
  • Active P&C or Personal Lines producer license
  • Prior experience with CRM systems
  • Strong critical thinking skills with the ability to analyze available information to make decisions in alignment with our risk appetite
  • Strong verbal and written communication skills
  • Ability to work in a fast-paced environment and multi-task effectively
  • Strong ability to work independently as part of a virtual team
  • Positive customer and quality focus

#LI-RD1

EEO Statement:

Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc.and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

Benefits:

We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https://www.phly.com/Careers/default.aspx


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