ZipRecruiter

Log In

2

Remote Insurance Utilization Review Jobs in Madison, WI

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · On-site +1

$34.50 - $44/hr

Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · On-site +1

$34.50 - $44/hr

Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Madison, WI · Remote

$34.50 - $44/hr

Comprehensive health and life insurance. * 401K with discretionary match * Mileage and licensure ... Review and verify MDS documentation and charting requirements to support the clinical services ...

State of Wisconsin

Insurance Accounting Director

Madison, WI · On-site +1

$101K - $113K/yr

For more information, please review the full position description Salary Information This position ... Job Details ETF offers hybrid remote/office workIf interested in hybrid remote/office work, this ...

WPS

Senior IT Security Analyst

Madison, WI · On-site +1

$90K - $115K/yr

... utilization. * Have developed security awareness training programs to educate employees on ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...

Agrace

Benefit & Compensation Analyst (on site)

Madison, WI · Remote

$70K - $87K/yr

Madison, WI Full Time | Day | Monday-Friday | 8am-5pm (option for 1 Day/Week remote) Make a lasting ... Review and evaluate self-funded health insurance claims data with assistance from our benefits ...

WPS

Medicare Pricing Analyst

Madison, WI · On-site +1

Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ... Health insurance, dental insurance, and telehealth services start DAY 1 * Professional and ...

next page

Showing results 1-20

All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Madison, WI

Remote Insurance Utilization Review information

See Madison, WI salary details

$21

$42

$69

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

As of Aug 29, 2026, the average hourly pay for remote insurance utilization review in Madison, WI is $42.60, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $48.94 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 Madison, WI?

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

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

The top searched job categories for Remote Insurance Utilization Review jobs in Madison, WI are:

Remote Insurance Utilization Review jobs near you
Infographic showing various Remote Insurance Utilization Review job openings in Madison, WI as of June 2026, with employment types broken down into 65% Full Time, 26% Part Time, 3% Temporary, 3% Contract, and 3% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $88,617 per year, or $42.6 per hour.

Remote Sales Representative

Madison, WI • Remote

Cha & Associates, Inc. - American Family Insurance
See more jobs at Cha & Associates, Inc. - American Family Insuranceexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 10 days ago

Job description

Benefits:
  • Life insurance
  • 401(k) matching
  • Bonus based on performance
  • Dental insurance
  • Health insurance
  • Opportunity for advancement
  • Paid time off
  • Training & development
  • Vision insurance

Grow Your Sales Career with a Trusted Agency
Are you a motivated sales professional who enjoys building relationships, achieving goals, and helping people protect what matters most? Are you looking for an opportunity where your hard work is rewarded and your earning potential is driven by your success?
Cha & Associates Inc. is seeking an Insurance Sales Representative to join our growing American Family Insurance agency in Madison, WI. This is a sales-focused role designed for someone who enjoys prospecting, developing new business, and closing opportunities while delivering an outstanding customer experience.
If you're competitive, driven, and excited to build a rewarding career with a respected local agency, we'd love to hear from you.
Why Join Cha & Associates?
  • Uncapped commission opportunities to take ownership and control of your own income.
  • Performance-based bonuses and incentives.
  • Ongoing training, coaching, and professional development.
  • Established agency with a loyal customer base and strong community reputation.
  • Supportive, collaborative team environment.
  • Opportunities for career growth and advancement.
What You'll Do
As an Insurance Sales Representative, you'll focus on generating new business while helping clients find personalized insurance solutions that fit their needs.
Responsibilities
  • Prospect and develop new business through referrals, networking, community outreach, and lead follow-up.
  • Build relationships with prospective clients and earn their trust through consultative conversations.
  • Conduct needs-based insurance reviews and recommend appropriate coverage solutions.
  • Educate customers on insurance products, policy features, discounts, and available coverage options.
  • Follow up consistently with prospects and maintain an active sales pipeline.
  • Cross-sell and bundle insurance products to provide comprehensive protection.
  • Meet and exceed individual sales goals and agency production objectives.
  • Maintain accurate customer records and sales activity within agency systems.
What We're Looking For
  • Previous sales experience strongly preferred.
  • Insurance sales experience is a plus but not required.
  • Property & Casualty Insurance License is preferred or willingness to obtain after hire.
Ideal Candidate
  • Confident, outgoing, and relationship-driven.
  • Excellent communication and interpersonal skills.
  • Self-motivated with a strong desire to achieve goals.
  • Competitive mindset and results-oriented attitude.
  • Organized with strong time-management skills.
  • Comfortable prospecting, making outbound calls, and asking for the sale.
  • Positive, coachable, and eager to continue learning.
Who Thrives in This Role?
Our most successful sales professionals enjoy meeting new people, creating opportunities, and building lasting relationships. They embrace challenges, stay motivated by goals, and take pride in helping clients make informed decisions while growing their own careers.
At Cha & Associates, we believe success comes from investing in great people. We'll provide the training, support, and resources you need to grow your skills, maximize your earning potential, and build a long-term career with one of the most trusted names in insurance.
Apply today and join the Cha & Associates Inc. team in Madison, WI!

This is a remote position.