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Urgently Hiring Insurance Utilization Review Jobs

Franciscan Health

Utilization Review Coordinator

Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care ... Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing ... Comprehensive medical and supplemental health insurance, including vision, dental, life insurance ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

... insurance companies/authorizing entities to ensure initial precertification and continued ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!

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

As of Jul 16, 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.
What cities are hiring for Urgently Hiring Insurance Utilization Review jobs? Cities with the most Urgently Hiring Insurance Utilization Review job openings:
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 Review Coordinator

Utilization Review Coordinator

Catholic Charities Diocese of Paterson

Parsippany, NJ • On-site

$32.80/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New

Job description

Are you passionate about making a difference in the lives of others?
Since 1938 we have grown to over 70 programs, providing assistance to individuals and families throughout the Diocese of Paterson and beyond - we provide help and create hope for thousands of people each day. Our ability to deliver support, education, sustenance and so much more to those in need is extensive. Through Catholic Family and Community Services, the Department for Persons with Disabilities and Straight and Narrow we offer life-changing resources in multiple facets for the families and individuals we serve. We truly have a rich history of providing essential services to our communities.
TITLE: Utilization Review (UR) Coordinator
Location: Parsippany NJ
Hours: Full Time (Monday through Friday: 8:30am - 4:30pm)
This is an hourly non-exempt position.
Salary: Up to $32.80 (with experience)
Job Summary
The Utilization Review Coordinator is responsible for securing and maintaining payer authorizations for behavioral health services, ensuring medical necessity, appropriate level of care placement, and reimbursement optimization. This role serves as the liaison between clinical teams, admissions, and insurance payers to support continuity of care and financial sustainability.
Qualifications
  • Bachelor's degree required, master's preferred
  • 2-5+ years in behavioral health, substance use treatment, or utilization review
  • Experience with insurance authorization processes and medical/clinical necessity criteria
  • Familiarity with ASAM criteria strongly preferred
  • Strong clinical documentation review skills
  • Knowledge of payer systems (State Contracts, FFS Initiatives, Medicaid, MCO, Third Party)
  • Excellent communication and negotiation skills
  • Detail-oriented with strong organizational abilities
  • Ability to manage multiple cases and deadlines

Benefits: For full time positions, (30+ per week) we offer:
  • We provide PAID training
  • Medical/vision and dental
  • Life insurance (agency-paid), supplemental life insurance (employee-paid)
  • Flexible spending accounts
  • Accidental/Critical Illness Insurance
  • 403B (with company-matching)
  • Generous paid time off

All offers of employment are contingent on the successful completion/passing of our criminal background/references/DMV check, fingerprinting, pre-employment physical and drug test, etc.

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