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Remote Insurance Utilization Review Jobs in Melbourne, FL

L3HHCM20

Sr. Specialist PCB Designer-REMOTE

Melbourne, FL · On-site +1

$91K - $170K/yr

... reviews with stakeholders, and releasing PCB & CCA drawings. Essential Functions: * Place and route ... L3Harris also offers a variety of benefits, including health and disability insurance, 401(k) match ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Melbourne, FL

Remote Insurance Utilization Review information

See Melbourne, FL salary details

$19

$39

$63

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

As of Sep 10, 2026, the average hourly pay for remote insurance utilization review in Melbourne, FL is $39.19, according to ZipRecruiter salary data. Most workers in this role earn between $30.96 and $45.00 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 Melbourne, FL?

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

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

The top searched job categories for Remote Insurance Utilization Review jobs in Melbourne, FL are:

What cities near Melbourne, FL are hiring for Remote Insurance Utilization Review jobs?

Cities near Melbourne, FL with the most Remote Insurance Utilization Review job openings:

Remote Insurance Utilization Review jobs near you

Insurance Producer (Remote)

Melbourne, FL • On-site, Remote

Spieldenner Financial Group
Finance and Insurance • 51 - 200 employees
Learn more about Spieldenner Financial Groupexternal

$10K - $20K/wk

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Spieldenner Financial Group is hiring motivated individuals to help families protect their income through mortgage protection coverage.
No experience? No problem. We provide training, mentorship, and a proven system to help you succeed.
What You'll Do
  • Contact clients who requested information
  • Set appointments and review their needs
  • Present coverage options (virtual or in-person)
  • Help families apply for protection
What We're Looking For
  • Coachable and self-motivated
  • Strong work ethic
  • Growth mindset
  • Comfortable working independently

Flexible Work Options:
  • Spare Time (4-8 hrs/week): $500-$2,000/month potential*
  • Part-Time (8-25 hrs/week): $2,000-$5,000/month potential*
  • Full-Time (25-50 hrs/week): $10,000-$20,000+/month potential*
Why Spieldenner Financial Group?
  • Comprehensive training and ongoing mentorship
  • Proven systems and lead support
  • Fully remote, flexible work environment
  • Growth-focused culture with advancement opportunities

Apply today to learn more and get started.
No agent's success, earnings, or production results should be viewed as typical, average, or expected. Not all agents achieve the same or similar results, and no particular results are guaranteed. Your level of success will depend on factors including your effort, ability to follow training and systems, engagement with leads, and client needs in your area.

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