ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs in Alton, IL (NOW HIRING)

Workforce Connections

Denial Specialist

Saint Louis, MO · Remote

$22/hr

Denials Specialist (Remote) Pay Rate: $22.47/hour Assignment Length: 6-12 months (with potential to ... Experience with denials, appeals, or utilization management * Background as a CNA, CMA, Radiology ...

Varsity Tutors

NCLEX-PN Tutor

Saint Louis, MO · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Varsity Tutors

NCLEX Tutor

Saint Louis, MO · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

ITW

National Sales Manager

MO · Remote

The role is a remote position; location base will be reviewed as this position covers all regions ... Enhance data utilization capabilities and enable stronger data led decision making in setting ...

Cybercoders

Tax Manager

Saint Louis, MO · On-site +1

$107K - $141K/yr

... Compliance & Reviews, & other Business Advisory Services. Our team of experts has years of ... REMOTE OR HYBRID SCHEDULE (Must be located in the state of MO) - Fast Track Partner Options ...

New

next page

Showing results 1-20

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Alton, IL

Remote Utilization Review Rn information

See Alton, IL salary details

$20

$40

$66

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

As of Jul 16, 2026, the average hourly pay for remote utilization review rn in Alton, IL is $40.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $46.68 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What cities near Alton, IL are hiring for Remote Utilization Review Rn jobs? Cities near Alton, IL with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Alton, IL as of July 2026, with employment types broken down into 85% Full Time, 10% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $84,570 per year, or $40.7 per hour.
Denial Specialist

Denial Specialist

Workforce Connections

Saint Louis, MO • Remote

$22/hr

Contractor

Posted 8 days ago

Job description

Job Title: Denials Specialist (Remote)

Pay Rate: $22.47/hour
Assignment Length: 6-12 months (with potential to extend or convert)

Shifts Available:

Shift 1: 1 -10 pm CST Tuesday-Saturday. Training required during standard business hours.

Shift 2: 8-5pm CST Tuesday - Saturday. Training required during standard business hours.

Shift 3:  1-10 pm CST Sunday-Thursday. Training required during standard business hours.

Shift 4:  8-5pm CST Monday-Friday. Training required during standard business hours.

Shift 5:  8-5pm CST Sunday-Thursday. Training required during standard business hours.

Position Overview

This role is responsible for generating, processing, and maintaining provider and member correspondence related to preservice and concurrent reviews. The position supports denial communications by accurately producing letters from medical documentation while meeting regulatory timelines and quality standards.

This is a non-member-facing, independent role that requires strong attention to detail, written communication skills, and comfort working across multiple systems.

Key Responsibilities

  • Generate and process denial and authorization correspondence using EMR documentation
  • Ensure all correspondence is completed accurately and within required turnaround times
  • Maintain and update correspondence templates based on regulatory and internal requirements
  • Support data tracking and reporting related to the denial process
  • Assist with monitoring correspondence turnaround times
  • Perform additional administrative tasks as assigned

Performance Expectations

  • Complete an average of 4 letters per hour
  • Maintain 95% accuracy, including grammar and punctuation
  • Meet turnaround time requirements based on line of business
  • Work independently while prioritizing time-sensitive tasks

Required Qualifications

  • High School Diploma or GED
  • 1–2 years of related healthcare or administrative experience
  • Strong written English skills (accuracy and punctuation are critical)
  • Basic knowledge of medical terminology
  • Advanced computer skills and ability to work in multiple systems simultaneously

Preferred Qualifications

  • Experience with denials, appeals, or utilization management
  • Background as a CNA, CMA, Radiology Tech, Sonography Tech, or Coding Certification
  • Familiarity with EMR systems and medical documentation

Tools & Systems Used

  • TruCare
  • Microsoft Excel, Word, Outlook, Teams
  • OneDrive and OneNote
  • Faxing and document management tools

Additional Notes

  • Role does not involve direct interaction with members or providers
  • Typing accuracy of 90% or higher is required (speed is less important than accuracy)
  • Candidates with only call center experience may not be a fit

CLIENT does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.