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Remote Insurance Utilization Review Jobs (NOW HIRING)

Pacer Group

RN - UTILIZATION REVIEW

Everett, WA · Remote

$65/hr

Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8 ...

Enterprise Engineering

Be Seen First

Concurrent Utilization Review (UR) Nurse

OR · Remote

$30 - $38/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in California The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time ...

Ascension

Registered Nurse Utilization Review

$84K - $118K/yr

Remote Department/Specialty: Ascension Care Management Insurance Schedule: Full Time | Days Salary ... Comprehensive Clinical Review: Conduct prospective, concurrent, and retrospective medical necessity ...

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Remote Insurance Utilization Review information

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

As of Jun 20, 2026, the average hourly pay for remote insurance utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.
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What are the most commonly searched types of Insurance Utilization Review jobs? The most popular types of Insurance Utilization Review jobs are:
What states have the most Remote Insurance Utilization Review jobs? States with the most job openings for Remote Insurance Utilization Review jobs include:
What job categories do people searching Remote Insurance Utilization Review jobs look for? The top searched job categories for Remote Insurance Utilization Review jobs are:
Remote Insurance Utilization Review jobs near you
Physician Reviewer - Psychiatry (Utilization Review)

Physician Reviewer - Psychiatry (Utilization Review)

Dane Street, LLC

New York, NY • Remote

Contractor

Posted 4 days ago

Job description

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Psychiatrist with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews.

This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established.

Key Responsibilities:

  • Review medical records to determine the medical necessity of services
  • Utilize state-specific workers' compensation guidelines and nationally recognized criteria
  • Submit clear, concise, and well-supported determinations
  • Complete reviews within required timeframes (typically 1-5 business days)
  • Participate in peer-to-peer calls as needed (coordinated by Dane Street)
  • Complete addenda when new information is provided

Role Highlights:

  • Independent contractor (1099) status
  • Average case takes 15 minutes or less
  • Flat rate per case - consistent, supplemental income
  • Fully remote - work from anywhere
  • You control volume and availability
  • No direct patient interaction or treatment
  • Chronological, pre-organized medical records provided
  • User-friendly portal and streamlined case management
  • Full onboarding and ongoing support included

Requirements:

  • Board Certification in Psychiatry
  • Active, unrestricted New York medical license
  • Workers' Compensation Board Certification (New York)
  • Active clinical practice

About Dane Street:
Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system.

Apply today to join our Physician Review Panel and start earning on your schedule.

Apply