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Urgently Hiring Insurance Utilization Review Jobs

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

This position collaborates closely with clinical teams, insurance providers, and other healthcare ... hiring process and employment. If you require assistance or accommodation, please let us know.

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

This position collaborates closely with clinical teams, insurance providers, and other healthcare ... hiring process and employment. If you require assistance or accommodation, please let us know.

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

This position collaborates closely with clinical teams, insurance providers, and other healthcare ... hiring process and employment. If you require assistance or accommodation, please let us know.

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

As of Jul 13, 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 and what does the job involve?

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, and why are they important?

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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Urgently Hiring Insurance Utilization Review jobs near you
UTILIZATION REV SPEC I

UTILIZATION REV SPEC I

Aspire Health Partners

Orlando, FL • On-site

Other

Re-posted 25 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

UTILIZATION REV SPEC I
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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