Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
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Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
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Registered Nurse - Clinical Documentation
Toronto, ON · Remote
CA$60 - CA$80/hr
Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ... Experience in CDI, case management, utilization review, or quality improvement. * Exposure to ...
Insurance Producer - Commission Based
Whitby, ON · Remote
CA$60K - CA$200K/yr
Insurance Producer (Commission-Based) Distinct Insurance O/B Begin Insurance Inc | Fully Remote ... Participate in regular performance reviews and adapt strategies for continued growth What We're ...
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Insurance Producer - Commission Based
Whitby, ON · Remote
CA$60K - CA$200K/yr
Insurance Producer (Commission-Based) Distinct Insurance O/B Begin Insurance Inc | Fully Remote ... Participate in regular performance reviews and adapt strategies for continued growth What We're ...
Host regular/weekly project review and create reports with key metrics about team and project ... Insurance domain knowledge is a must * Strong client facing experience is a must * Technical skills ...
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Host regular/weekly project review and create reports with key metrics about team and project ... Insurance domain knowledge is a must * Strong client facing experience is a must * Technical skills ...
Host regular/weekly project review and create reports with key metrics about team and project ... Insurance domain knowledge is a must * Strong client facing experience is a must * Technical skills ...
Host regular/weekly project review and create reports with key metrics about team and project ... Insurance domain knowledge is a must * Strong client facing experience is a must * Technical skills ...
Commercial Insurance Renewals Broker (Remote First)
Toronto, ON · Remote
CA$52K - CA$80K/yr
Carefully reviewing all account policy data for accuracy and ensuring zero errors in client ... Market Advocacy: Liaising with insurance partners to negotiate and create the best possible ...
Commercial Insurance Renewals Broker (Remote First)
Toronto, ON · Remote
CA$52K - CA$80K/yr
Carefully reviewing all account policy data for accuracy and ensuring zero errors in client ... Market Advocacy: Liaising with insurance partners to negotiate and create the best possible ...
Commercial Insurance Claims Advisor (Remote First)
Toronto, ON · On-site +1
CA$50K - CA$68K/yr
Support the creation and review of internal process flows, job aids, guides, and lesson plans ... Commercial Insurance Experience: 2+ years of commercial lines insurance experience. * Claims ...
Commercial Insurance Claims Advisor (Remote First)
Toronto, ON · On-site +1
CA$50K - CA$68K/yr
Support the creation and review of internal process flows, job aids, guides, and lesson plans ... Commercial Insurance Experience: 2+ years of commercial lines insurance experience. * Claims ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
Resolve issues to the customer's satisfaction through experience and utilization of available ... reviewer makes all final decisions. This posting is for an existing vacancy. About the Team At ...
Resolve issues to the customer's satisfaction through experience and utilization of available ... reviewer makes all final decisions. This posting is for an existing vacancy. About the Team At ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
This is far more than a typical reviewer role-this position serves as the internal practice leader ... utilization, realization, turnaround times, and quality control to ensure firm KPIs are ...
We're looking for a Renewals Specialist to join our Insurance team in Ontario, (fully remote role ... Review policies and make recommendations as required * Adhere to the underwriting criteria set out ...
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We're looking for a Renewals Specialist to join our Insurance team in Ontario, (fully remote role ... Review policies and make recommendations as required * Adhere to the underwriting criteria set out ...
Account Executive - Commercial Lines
Oakville, ON · Remote
CA$50K - CA$60K/yr
Review client needs and provide tailored insurance solutions * Support retention and account ... Ability to work independently in a remote setting * Organized, detail-oriented, and able to manage ...
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Account Executive - Commercial Lines
Oakville, ON · Remote
CA$50K - CA$60K/yr
Review client needs and provide tailored insurance solutions * Support retention and account ... Ability to work independently in a remote setting * Organized, detail-oriented, and able to manage ...
Bilingual Claims Service Representative-Remote
Toronto, ON · Remote
CA$35K - CA$48K/yr
... report insurance claims. Document initial loss details and activities to ensure that callers ... Responsibilities Review call report and ensure call has terminated properly, then forward accurate ...
Bilingual Claims Service Representative-Remote
Toronto, ON · Remote
CA$35K - CA$48K/yr
... report insurance claims. Document initial loss details and activities to ensure that callers ... Responsibilities Review call report and ensure call has terminated properly, then forward accurate ...
Commercial Insurance Accounts Broker (Remote First)
Toronto, ON · Remote
CA$52K - CA$80K/yr
About Us: Zensurance is redefining commercial insurance for Canadian businesses. As a leading ... Carefully reviewing all new submissions and policy data for accuracy while managing complex policy ...
Commercial Insurance Accounts Broker (Remote First)
Toronto, ON · Remote
CA$52K - CA$80K/yr
About Us: Zensurance is redefining commercial insurance for Canadian businesses. As a leading ... Carefully reviewing all new submissions and policy data for accuracy while managing complex policy ...
Bilingual Overnight Claims Service Representative-remote
Mississauga, ON · Remote
CA$35K - CA$48K/yr
... report insurance claims. Document initial loss details and activities to ensure that callers ... Review call report and ensure call has terminated properly, then forward accurate and complete call ...
Bilingual Overnight Claims Service Representative-remote
Mississauga, ON · Remote
CA$35K - CA$48K/yr
... report insurance claims. Document initial loss details and activities to ensure that callers ... Review call report and ensure call has terminated properly, then forward accurate and complete call ...
Remote Tele-Interviewer - Health Care
Brampton, ON · Remote
CA$20.25/hr
... insurance provider requirements and questionnaire formats. * Apply feedback received through quality assurance reviews to continuously improve interview techniques and overall performance. * Work ...
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Remote Tele-Interviewer - Health Care
Brampton, ON · Remote
CA$20.25/hr
... insurance provider requirements and questionnaire formats. * Apply feedback received through quality assurance reviews to continuously improve interview techniques and overall performance. * Work ...
Remote Insurance Utilization Review information
What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?
| Aspect | Remote Insurance Utilization Review | Remote Claims Reviewer |
|---|---|---|
| Credentials | Typically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professional | Usually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H |
| Work Environment | Remote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of services | Remote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance |
| Industry Usage | Commonly used in healthcare insurance to evaluate medical necessity | Used 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 popular job titles related to Remote Insurance Utilization Review jobs in Toronto, ON? For Remote Insurance Utilization Review jobs in Toronto, ON, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Utilization Review jobs in Toronto, ON look for? The top searched job categories for Remote Insurance Utilization Review jobs in Toronto, ON are:
- Utilization Review 1099
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CA$80/hr
Full-time
Posted 27 days ago
Job description
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.
Position: Registered Nurses (Data labelling and training)
Type: Contract
Compensation: $60–$80/hour
Location: Remote
Role Responsibilities
- Review and assess clinical documentation for accuracy, completeness, and quality.
- Analyze healthcare workflows and recommend process improvements.
- Interpret patient records and clinical notes to support product development.
- Identify documentation gaps, inconsistencies, and edge cases.
- Collaborate with product, engineering, and operations teams to refine AI-driven healthcare tools.
- Ensure adherence to healthcare regulations, policies, and best practices.
Qualifications
Must-Have
- Active Registered Nurse (RN) license.
- 3–5+ years of clinical nursing experience.
- Strong understanding of clinical documentation and healthcare workflows.
- Experience working with EHR systems (Epic, Cerner, Meditech, etc.).
- Excellent analytical, communication, and problem-solving skills.
Preferred
- Experience in CDI, case management, utilization review, or quality improvement.
- Exposure to healthcare technology, AI tools, or digital health products.
- Ability to collaborate effectively with cross-functional teams.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
- For any help or support, reach out to: support@mercor.com
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.