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Utilization Review 1099 Jobs (NOW HIRING)

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

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Utilization Review 1099 information

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How much do utilization review 1099 jobs pay per hour?

As of Jul 10, 2026, the average hourly pay for utilization review 1099 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 are some typical challenges faced by Utilization Review professionals working as 1099 contractors, and how can they be managed?

Utilization Review professionals working as 1099 contractors often face challenges such as fluctuating caseloads, varying client requirements, and the need to stay current with changing regulations independently. Unlike full-time employees, contractors must also manage their own schedules, billing, and sometimes provide their own resources and training. To succeed, it's important to establish clear communication with clients, maintain up-to-date credentials, and leverage professional networks or continuing education resources to stay informed about industry changes.

What are the key skills and qualifications needed to thrive as a Utilization Review 1099, and why are they important?

To thrive as a Utilization Review 1099 professional, you need a strong clinical background (often as a registered nurse or similar), experience with medical necessity criteria, and familiarity with insurance guidelines. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory requirements are typically required, along with URAC or CCM certification being advantageous. Excellent analytical thinking, attention to detail, and effective communication skills are essential for collaborating with healthcare providers and payers. These skills ensure accurate, efficient review of patient care for coverage decisions, compliance, and cost-effective healthcare delivery.

What is a Utilization Review 1099 position?

A Utilization Review 1099 position refers to a healthcare professional, often a nurse or therapist, who works as an independent contractor (not a direct employee) to review medical cases for necessity and efficiency. The '1099' designation means they receive a Form 1099 for tax purposes and are responsible for their own taxes. Utilization Review specialists evaluate patient records to ensure treatments are appropriate and meet insurance or regulatory guidelines. These roles are often remote and offer flexible hours, but do not provide traditional employee benefits.

What is the difference between Utilization Review 1099 vs Utilization Review Nurse?

AspectUtilization Review 1099Utilization Review Nurse
CredentialsVaries; often self-employed or independent contractorsRegistered Nurse (RN) license required
Work EnvironmentRemote or freelance; contract basisHealthcare facilities, insurance companies, or clinics
Employer/Industry UsageFreelance or independent consulting in healthcareHospitals, insurance providers, healthcare organizations
Work FocusReviewing medical necessity for insurance claimsAssessing patient records, making clinical decisions

Utilization Review 1099 typically refers to independent contractors reviewing insurance claims, often working remotely. Utilization Review Nurse is a licensed RN performing clinical assessments within healthcare settings. While both roles involve utilization review, the 1099 role emphasizes independent contracting, whereas the nurse role requires clinical credentials and direct patient or clinical record involvement.

More about Utilization Review 1099 jobs
What cities are hiring for Utilization Review 1099 jobs? Cities with the most Utilization Review 1099 job openings:
What states have the most Utilization Review 1099 jobs? States with the most job openings for Utilization Review 1099 jobs include:
What job categories do people searching Utilization Review 1099 jobs look for? The top searched job categories for Utilization Review 1099 jobs are:
Utilization Review 1099 jobs near you
Utilization Review Specialist

Utilization Review Specialist

Recovery Unplugged

Fort Lauderdale, FL • On-site

$30K - $40K/yr

Part-time

Posted yesterday

New

Job description

Description:

Utilization Review Specialist (Part-Time – Weekends)


Location: Remote

Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South Carolina, or New Jersey are strongly encouraged to apply.


Job Details

Job Type: Part-Time

Schedule:

  • 16–24 hours per week
  • Weekend availability required
  • Ideal schedule is Friday through Monday, working 2–3 days within that timeframe
  • Schedule may vary based on business needs
About Recovery Unplugged

Recovery Unplugged is a national leader in drug and alcohol addiction treatment, offering an innovative, evidence-based approach that integrates the healing power of music into recovery. With treatment centers across Florida, Texas, Virginia, New Jersey, South Carolina, and Tennessee, we are committed to delivering compassionate care that helps individuals build lasting recovery.


Position Summary

Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This position plays a critical role in ensuring patients receive the appropriate level of care by obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams throughout the treatment process.

The ideal candidate has prior experience in behavioral health utilization review, understands managed care guidelines, and is comfortable advocating for patients with insurance providers.


Essential Responsibilities
  • Conduct utilization reviews for admissions and continued stays to establish medical necessity and obtain insurance authorizations.
  • Review clinical documentation to support the appropriate level of care and length of stay.
  • Present clinical information to insurance companies and managed care representatives to obtain or extend authorizations.
  • Communicate with insurance case managers regarding benefits, coverage, and authorization status.
  • Collaborate with clinical staff to ensure documentation meets payer requirements.
  • Provide guidance to treatment teams regarding insurance criteria, continued stay requirements, and discharge planning.
  • Maintain accurate, timely, and organized documentation in accordance with company policies and regulatory standards.
  • Work collaboratively with multidisciplinary teams to support quality patient care and reimbursement.
  • Protect patient confidentiality and comply with all HIPAA and organizational policies.
  • Perform other duties as assigned.

Compensation
  • $30,000–$40,000 annually, depending on experience, qualifications, and whether the selected candidate works a 2-day or 3-day weekend schedule.
  • Benefits may be available based on eligibility.

Join a team that's transforming addiction treatment through compassionate, evidence-based care and the healing power of music. If you're passionate about advocating for patients and navigating the utilization review process, we'd love to hear from you.


Recovery Unplugged is an Equal Opportunity Employer.


Requirements:
  • Previous experience in Utilization Review, Managed Care, Behavioral Health, or a related healthcare setting required.
  • Experience working with substance use disorder or behavioral health treatment programs is strongly preferred.
  • Strong knowledge of insurance authorization processes and reimbursement practices.
  • Excellent verbal and written communication skills.
  • Strong organizational skills with the ability to manage multiple cases simultaneously.
  • Proficiency with electronic medical records (EMR) systems and Microsoft Office.
  • Current clinical licensure is preferred but not required. Candidates with significant utilization review experience will be considered.