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Remote Insurance Utilization Review Jobs in Raleigh, NC

MeridianLight

Be Seen First

Remote Insurance Agent (No Cold Calling, Training Provided)

Raleigh, NC · Remote

$60K - $110K/yr (+ commission)

MeridianLight provides pre-set retirement review appointments with teachers and public employees ... insurance license preferred OR willing to obtain one Additional Information This is a 100% remote ...

Senture

Medical Director

Raleigh, NC · Remote

... utilization review, credentialing, claims resolution, or medical review functions within commercial and/or government-sponsored health insurance programs. * Demonstrated knowledge of NCQA ...

Centene

Psychologist Reviewer

Durham, NC · On-site +1

$87K - $157K/yr

Centene is Hiring - Remote Psychologist Reviewers (ABA) Centene is seeking Remote Psychologist ... Interact with network practitioners to provide education on best practice models and utilization ...

Qualus

Lead Engineer - Distribution

Raleigh, NC · On-site +1

$99K - $131K/yr

Coordinate task assignments to maximize staff utilization. * Review of completed designs and design ... Life Insurance, Short and Long-Term Disability, 401(k) match, Flexible Spending Accounts, EAP ...

IQVIA

Director, Remote Research Clinicians

Durham, NC · Remote

Review quality metrics, issue trends, audit findings, and operational performance indicators to ... Evaluate workload, utilization, productivity, quality, and customer satisfaction metrics. * Support ...

IQVIA

Director, Remote Research Clinicians

Durham, NC · Remote

Review quality metrics, issue trends, audit findings, and operational performance indicators to ... Evaluate workload, utilization, productivity, quality, and customer satisfaction metrics. * Support ...

SIA Group

Insurance Sales Agent

Raleigh, NC · On-site +1

Conducting regular client reviews to identify gaps, strengthen relationships, and uncover new ... Work-life balance * Remote flexibility * Health insurance package * 401(k) * Unlimited PTO

Atlantic BT

Digital Project Manager

Raleigh, NC · On-site +1

We provide a collaborative, remote-first environment where team members advance their skills across ... Lead project planning, milestone scheduling, and feature reviews prior to deployment. * Demonstrate ...

Atlantic BT

Digital Project Manager

Raleigh, NC · Remote

We provide a collaborative, remote-first environment where team members advance their skills across ... Lead project planning, milestone scheduling, and feature reviews prior to deployment. * Demonstrate ...

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Remote Insurance Utilization Review information

See Raleigh, NC salary details

$20

$41

$67

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

As of Sep 7, 2026, the average hourly pay for remote insurance utilization review in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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 Raleigh, NC?

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

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

The top searched job categories for Remote Insurance Utilization Review jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Remote Insurance Utilization Review jobs?

Cities near Raleigh, NC 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 Raleigh, NC as of August 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 100% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Remote Insurance Agent (No Cold Calling, Training Provided)

MeridianLight

Raleigh, NC • Remote

$60K - $110K/yr (+ commission)

Full-time

Retirement

Posted 13 days ago

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Job description

Remote Sales Closer – Financial Services (Warm Leads, Pre-Set Appointments Provided)

Stop wasting 80% of your day prospecting. We provide the appointments; you provide the closing skills. This is a 100% remote role for hungry sales professionals who want to focus on high-ticket commissions.

MeridianLight provides pre-set retirement review appointments with teachers and public employees seeking guidance on retirement income, protection, and tax-efficient planning. Representatives work remotely helping clients explore solutions that may include indexed strategies, protection products, and annuity-based options.

The Money

  • Commission: 70% – 90% (Industry Leading)
  • Average Pay per Sale: $2,000 – $3,000+
  • Top Producers: $10,000 – $25,000+ per month

What You Get

• Pre-set appointments available (no cold calling)
• Remote work / flexible schedule
• Training, mentorship, and onboarding support
• Access to multiple highly rated insurance carriers
• Strong commission upside and growth opportunity

What You’ll Do

• Meet with clients through virtual appointments
• Educate clients on life insurance, retirement planning, annuities, and income protection products
• Help clients understand coverage and financial options
• Build client relationships and guide informed decisions

Requirements

• Strong communication skills
• Self-motivated and coachable
• Reliable and professional
• Life insurance license preferred OR willing to obtain one

Additional Information

This is a 100% remote opportunity for motivated professionals seeking flexible income growth. Position is performance-based and commission compensated (1099) with training and pre-set appointments available.