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Remote Utilization Review Jobs in Meridian, ID (NOW HIRING)

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Remote Utilization Review information

See Meridian, ID salary details

$20

$40

$66

How much do remote utilization review jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for remote utilization review in Meridian, ID is $40.99, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.07 per hour, depending on experience, location, and employer.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What are the most commonly searched types of Utilization Review jobs in Meridian, ID?

The most popular types of Utilization Review jobs in Meridian, ID are:

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For Remote Utilization Review jobs in Meridian, ID, the most frequently searched job titles are:

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Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Meridian, ID as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $85,257 per year, or $41 per hour.

*New - Prior Authorization Specialist (Experienced)- Washington, Idaho, Oregon - Remote

Boise, ID • On-site, Remote

Nyx Health
Health Care and Social Assistance • 11 - 50 employees
Learn more about Nyx Healthexternal

$21 - $23/hr

Full-time

Medical, Dental, PTO

Posted 9 days ago

Job description

Prior Authorization Specialist - Remote - Washington, Idaho, Oregon
Position Summary
We're looking for a Prior Authorization Specialist with extensive, hands-on experience working insurance authorizations in EPIC. EPIC proficiency is mandatory. Extensive knowledge of Idaho payors is mandatory. This is not an entry-level training position, and candidates who require training on EPIC or lack significant experience working with Idaho payors will not be considered. The successful candidate must be able to step in and work independently from day one. You will be responsible for completing insurance verifications, submitting and tracking prior authorizations, gathering required documentation, communicating with insurance payors and clinicians, and following authorizations through to approval.
Key Responsibilities:
  • Extensive hands-on proficiency in EPIC, including prior authorization workflows.
  • Extensive knowledge of Idaho payors, including their authorization requirements, processes, and requirements.
  • Proven experience navigating complex insurance authorization requirements.
  • Ability to independently manage prior authorizations from submission through approval.
  • Communicate with providers and insurance companies regarding authorization status.
  • Maintain HIPAA compliance and support daily revenue cycle operations.

Skills & Qualifications
  • 5+ years of prior authorization experience -Required
  • Proficient EPIC
  • Strong communication, problem-solving, and organizational skills.
  • Detail-oriented, analytical, and able to multitask in a fast-paced environment.
  • Proficient in TEAMS

Education & Experience
  • High School Diploma required; additional education in business or healthcare preferred.
  • Experience in prior authorization, utilization review, insurance verification, and EMR systems.

[preferred]
Work Environment & Physical Requirements
  • Remote position
  • Prolonged computer use; ability to lift up to 15 lbs.
  • Reliable Internet
  • FT M-F - 40 hour work week - PST time zone
  • Hours available between 7am - 6pm

Job Type, Schedule & Compensation
Full-time, Monday-Friday, 8-hour day shift.
Pay: $21-$23 per hour, [With additional pay available for exceptional experience.]
High performers will also be eligible for a performance bonus incentive.
Benefits:
  • Dental insurance
  • Health Insurance
  • Accrued Paid Time Off

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