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Remote Insurance Utilization Review Jobs in Rochester, NY

Athena

LCSW Clinical Supervisor - Remote

Rochester, NY · Remote

$65K - $120K/yr

While this is a remote position, candidates must reside in or be willing to relocate to one of the ... Engage in the Utilization Review process for assigned cases every month * Respond to clinical ...

Athena

Remote Psychotherapist

Rochester, NY · Remote

$50K - $100K/yr

Life Insurance Coverage and Malpractice Insurance * W-2 Weekly Pay! Responsibilities: * Conducts ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

IDEX

Assistant Controller

West Henrietta, NY · On-site +1

... reviews Reports key performance indices (KPI) for Operations, analyzes variances and provides ... This position is a remote role; however, we are seeking candidates who reside within reasonable ...

Deloitte

Hospital Billing Coordinator

Rochester, NY · Remote

$50K - $60K/yr

This is a primarily remote role supporting enterprise Epic implementation, with minimal travel and ... Review patient accounts, charge details, coding inputs, and supporting documentation for billing ...

Deloitte

Hospital Billing Operator

Rochester, NY · Remote

$18 - $23.25/hr

This is a primarily remote role supporting an enterprise Epic implementation, with minimal travel ... Review patient accounts, charge details, coding inputs, and supporting documentation for billing ...

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All JobsInsurance Utilization Review JobsRemote Insurance Utilization Review JobsRemote Insurance Utilization Review Jobs in Rochester, NY

Remote Insurance Utilization Review information

See Rochester, NY salary details

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$41

$68

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

As of Jul 27, 2026, the average hourly pay for remote insurance utilization review in Rochester, NY is $41.72, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 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 Rochester, NY? The most popular types of Insurance Utilization Review jobs in Rochester, NY are:
What are popular job titles related to Remote Insurance Utilization Review jobs in Rochester, NY? For Remote Insurance Utilization Review jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Rochester, NY look for? The top searched job categories for Remote Insurance Utilization Review jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Remote Insurance Utilization Review jobs? Cities near Rochester, NY 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 Rochester, NY 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 $86,774 per year, or $41.7 per hour.

LCSW Clinical Supervisor - Remote

Athena

Rochester, NY • Remote

$65K - $120K/yr

Part-time

Posted 14 days ago

Job description

While this is a remote position, candidates must reside in or be willing to relocate to one of the following states prior to their start date:

Colorado, Connecticut, District of Columbia (Washington, D.C.), Florida, Massachusetts, Maryland, North Carolina, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington

Athena Mental Health is a New York State mental health-approved provider of community mental health services for children, adults, and families with behavioral and emotional challenges.  We specialize in individual and group psychotherapy for clients with a focus on trauma-informed care. We are dedicated to improving the quality and accessibility of mental health care for all, especially individuals from underserved communities.
 
Here at Athena, we pride ourselves on hiring a diverse group of mental health clinicians and staff who are passionate and dedicated to improving our clients’ overall emotional well-being. We provide both in-person and telehealth services for our clients and offer a competitive fee-for-service compensation plan and amazing benefits to our staff. 
 
Are You a Good Fit For Us?
We are currently seeking professional and compassionate Clinical Supervisors to join our growing team. Flexible hours are provided with the need of one weekend day and some evenings. In-person and telehealth sessions are conducted by our clinicians.
Responsibilities
  • Provide weekly clinical supervision to therapists as assigned, and document supervision sessions in a timely manner
  • Complete and maintain NYS licensure paperwork for supervisees as applicable
  • Assist with the development and facilitation of clinical training for staff in partnership with the leadership team
  • Work with the Clinical Director to cover administrative tasks as needed, including performance management of assigned therapists when necessary
  • Perform ongoing review of high-risk cases and provide clinical solutions as appropriate
  • Engage in the Utilization Review process for assigned cases every month
  • Respond to clinical crises and other clinical issues brought forward by supervisees
  • Help develop and improve clinical policies and procedures on an ongoing basis to support overall success of the program
  • Maintain a reduced caseload of therapy clients; complete all required clinical documentation promptly, including comprehensive assessments, treatment plans, and progress notes
Qualifications
  • NYS Independently Licensed Mental Health Provider (PhD, LCSW, LCSW-R, etc.)
  • Leadership experience in a mental health clinic setting
  • Bilingual in English and Spanish is preferred, but not required 
  • Previous experience using computerized appointment scheduling systems and/or electronic Medical Record Systems
  • Knowledgeable in NYS OMH Outpatient Clinic regulations
  • Knowledgeable in HIPAA Regulations
This is a fee-for-service role
Working Conditions
This position will be located at either the Manhattan office at 33 West 60th Street, New York, NY 10023, Suite 600, the Bronx office at 2825 Third Avenue, Suite 402, Bronx, NY 10455, 1299 Portland Ave, Suite 1, Rochester, NY 14621, or remotely. This is a professional work environment where a computer, desk, chair, and office supplies will be essential.
 
Physical Requirements
The physical demands described here are representative of those that must be met by an employee in order to successfully perform the essential functions of the role above. While performing the duties of this job, the employee is regularly required to hear and speak on the phone or through virtual telehealth sessions conducted on a computer throughout the day, stand and sit for an extended period of time and be able to write and answer emails in addition to carrying objects no greater than 25 pounds, when needed.
 
Direct Reports
This position has direct reports.
 
Athena is an Equal Opportunity Employer.
 
Note: We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions. 

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.