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Urgently Hiring Insurance Utilization Review Jobs

Enlyte

Utilization Reviewer 2

Tampa, FL

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Discovery Institute

Utilization Review

Marlboro, NJ · On-site

Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...

Genex Services

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Enlyte

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Prime Time Healthcare

Utilization Review

Cleveland, OH · On-site

Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...

New

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Medical, vision & dental insurance * 401(k) matching program * Flexible schedules * Travel ...

New

Prime Time Healthcare

Utilization Review

Washington, DC · On-site

Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...

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How much do urgently hiring insurance utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for urgently hiring 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 Urgently Hiring Insurance Utilization Review vs Insurance Claims Processor?

AspectUrgently Hiring Insurance Utilization ReviewInsurance Claims Processor
Primary RoleAssess medical necessity and appropriateness of services for insurance coverageReview and process insurance claims for payment and reimbursement
Required CredentialsLicenses or certifications in health insurance or medical review, often with healthcare backgroundKnowledge of insurance policies, claims processing systems, and basic healthcare understanding
Work EnvironmentHealthcare or insurance companies, often in office or remote settingsInsurance companies, healthcare providers, or third-party claims processing centers
Common Search/ComparisonUrgently Hiring Insurance Utilization Review vs Insurance Claims Processor

While both roles involve insurance and healthcare, Insurance Utilization Review focuses on evaluating the necessity of medical services, whereas Insurance Claims Processors handle the processing and payment of claims. Understanding these differences helps job seekers find the right position aligned with their skills and credentials.

What is an insurance utilization review?

An Insurance Utilization Review is a process used by insurance companies and healthcare organizations to evaluate the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities. Professionals in this role review patient records, treatment plans, and coverage policies to determine if the requested healthcare services meet established criteria for payment and care. Their work helps control healthcare costs, ensures quality care, and supports compliance with regulations. They often collaborate with physicians, nurses, and insurance providers to make informed decisions. Typically, strong analytical, communication, and clinical knowledge are required for this job.

What are the main challenges faced by professionals in insurance utilization review, and how can they be addressed?

One of the main challenges in Insurance Utilization Review is balancing the need to ensure appropriate patient care with the necessity of complying with insurance coverage criteria. This often involves interpreting complex medical records and guidelines under tight deadlines, while communicating effectively with healthcare providers and payers. Building strong organizational and communication skills, and staying updated on changing insurance policies and regulations, can help professionals navigate these challenges successfully. Collaboration with clinical teams and ongoing professional development are also key to thriving in this fast-paced environment.

What are the key skills and qualifications needed to thrive as an insurance utilization review specialist?

To excel as an Insurance Utilization Review Specialist, you generally need a healthcare background (often as an RN, LPN, or similar credential), strong analytical skills, and in-depth knowledge of medical terminology and insurance guidelines. Familiarity with utilization management software, electronic medical records (EMR), and certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Exceptional attention to detail, critical thinking, and effective communication with both healthcare providers and insurers set top performers apart. These skills ensure accurate coverage determinations, compliance with regulations, and cost-effective patient care management.
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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 Urgently Hiring Insurance Utilization Review jobs? States with the most job openings for Urgently Hiring Insurance Utilization Review jobs include:
Urgently Hiring Insurance Utilization Review jobs near you

UTILIZATION REV SPEC I

Aspire Health Partners

Orlando, FL

Full-time

Re-posted 20 days ago

Aspire Health Partners rating

4.8

Company rating: 4.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Behavioral Health Utilization Review Specialist I

Aspire Health Partners, Inc.

Make a Difference in Behavioral Health Care

At Aspire Health Partners, we are dedicated to transforming lives through compassionate, high-quality behavioral healthcare. As Florida’s largest nonprofit behavioral health provider, we serve diverse populations across Central Florida and are committed to clinical excellence and meaningful impact.

We are currently seeking a Utilization Review Specialist to join our team and play a key role in ensuring our clients receive the care they need while supporting effective coordination with insurance providers.

Position Summary

In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You’ll work closely with clinical teams, insurance representatives, and internal departments to ensure timely authorizations, support treatment planning, and contribute to high-quality patient outcomes.

Key Responsibilities

  • Partner daily with the Access Center and/or Crisis Response Center (CRC) to identify clients needing utilization review
  • Communicate clinical information to insurance reviewers to secure authorizations and extended lengths of stay
  • Collaborate with attending psychiatrists on clinical assessments and treatment recommendations
  • Participate in interdisciplinary treatment team meetings to support care for managed care clients
  • Provide constructive clinical feedback to enhance service delivery and patient care
  • Ensure accurate authorization details are submitted to Patient Accounts for billing
  • Review client charts for potential denial issues and support appeal processes when needed
  • Maintain strict adherence to ethical standards, confidentiality, and organizational policies

Qualifications

Required:

  • High School Diploma or equivalent
  • Level II Background clearance- All Aspire Health Partners Internships and Careers require Level 2 clearance, with Aspire covering fingerprinting costs. Click https://info.flclearinghouse.c... to learn more.
  • Valid driver’s license with an acceptable driving record per organizational guidelines

Preferred:

  • Experience in behavioral health, utilization review, or managed care environments
  • LPN or RN experience
  • Strong communication, documentation, and organizational skills

Why Join Aspire?

  • Mission-driven organization making a real impact in your community
  • Collaborative, team-focused work environment
  • Opportunities for growth and professional development
  • A role where your work directly supports quality care and patient outcomes

Equal Opportunity Employer

Aspire Health Partners is a drug-free workplace and an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will be considered without regard to race, color, religion, national origin, sex, age, disability, or veteran status.


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