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Utilization Reviewer Jobs in Indiana (NOW HIRING)

SIHO Insurance Services, Inc.

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Utilization Management Nurse

Columbus, IN · On-site

By performing review of services prospectively, retrospectively, and throughout the episode of care ... utilization review, and medical necessity * Act and perform within the scope of professional ...

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All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Indiana

Utilization Reviewer information

See Indiana salary details

$29.5K

$36.2K

$41.9K

How much do utilization reviewer jobs pay per year?

As of Jun 28, 2026, the average yearly pay for utilization reviewer in Indiana is $36,152.00, according to ZipRecruiter salary data. Most workers in this role earn between $32,400.00 and $40,000.00 per year, depending on experience, location, and employer.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How does a Utilization Reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What does a utilization reviewer do?

A utilization reviewer evaluates medical records and treatment plans to determine the necessity and appropriateness of healthcare services. They ensure that services comply with insurance policies and industry standards, often using healthcare management software and adhering to regulatory guidelines. This role supports cost containment and quality assurance in healthcare organizations.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a healthcare-related degree such as nursing, health administration, or a related field. Relevant experience in healthcare or insurance, strong analytical skills, and familiarity with medical coding and documentation are important; some roles may require certification such as the Certified Professional Utilization Review (CPUR).

What jobs pay 2000 a day?

Utilization reviewers typically do not earn $2000 a day; such high daily earnings are more common in specialized roles like senior surgeons, high-level consultants, or certain executive positions. These roles often require advanced certifications, extensive experience, and work in high-paying industries such as healthcare, finance, or law. Most utilization review positions offer salaries that are significantly lower than this daily rate.

What Does a Utilization Reviewer Do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

What job makes $10,000 a month without a degree?

A utilization reviewer typically earns between $4,000 and $8,000 per month, depending on experience and location, and usually requires relevant healthcare or insurance knowledge. Jobs that can pay $10,000 a month without a degree include high-level sales, real estate brokers, or certain skilled trades like commercial pilots or specialized technicians, often requiring certifications or extensive experience. These roles often involve self-employment, commissions, or high-demand skills that compensate well without formal college degrees.

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

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.
More about Utilization Reviewer jobs
What are popular job titles related to Utilization Reviewer jobs in Indiana? For Utilization Reviewer jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Utilization Reviewer jobs in Indiana look for? The top searched job categories for Utilization Reviewer jobs in Indiana are:
What cities in Indiana are hiring for Utilization Reviewer jobs? Cities in Indiana with the most Utilization Reviewer job openings:
What are popular job titles related to Utilization Reviewer jobs in IN? For Utilization Reviewer jobs in IN, the most frequently searched job titles are:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Indiana as of June 2026, with employment types broken down into 25% Full Time, 69% Part Time, and 6% Contract. Highlights an 51% Physical, 2% Hybrid, and 47% Remote job distribution, with an average salary of $36,152 per year, or $17.4 per hour.
Utilization Review Educator

Utilization Review Educator

Beacon Health System

Granger, IN • On-site

Full-time

Posted 5 days ago

Beacon Health System rating

6.6

Company rating: 6.6 out of 10

Based on 138 frontline employees who took The Breakroom Quiz

561st of 877 rated healthcare providers

Job description

Reports to the Manager/Utilization Review and Case Management. Is responsible for assessing, planning, coordinating and evaluating orientation, continuing education and in-service programs for staff which are competency based. Recommends improvements in the quality of utilization review practice and standards. Serves as a resource to staff. Assists with steps to resolve preventable denials and coordinates with the Manager to identify and correct weaknesses in the revenue cycle process that can mitigate future denials.
MISSION, VALUES and SERVICE GOALS
  • MISSION: We deliver outstanding care, inspire health, and connect with heart.
  • VALUES: Trust. Respect. Integrity. Compassion.
  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Orientation of New Hires
  • Develops curriculum and keeps current new hire orientation for all positions affecting UR at both hospitals and any other positions associated with UR Departments.
  • Develops schedules, teaching methods, evaluation tools, preceptor development programs, and coordinates for all parties a smooth onboarding and training process.
  • Works with manager to assure performance progress is documented and feedback whether positive or corrective for timely movement through orientation phase.

Continuing Education and Competency Validation
  • Assess learning needs of UR associates and develops plan, goals, and validates with management and associates.
  • Assures competency assessment of staff working in UR Process through audits, direct observations/discussions, and individual education plans as needed.
  • Responsible for all staff development activities around upgrades to UR tools, criteria sets, and other mechanisms/processes needed in UR process.
  • Assists as a resource regarding UR situations of concern and decision making.
  • Keeps records of all education and competency validation activities.

Project Management
  • Leads or participates in strategic initiatives in the revenue cycle where utilization review plays a role and communicates relevant information to other departments
  • Supports management communications and actions to assure effective change management culture in departments.

Performance/Process Improvement/Efficiency
  • Evaluates work processes, identifies inefficiencies, lack of standardization, and opportunities for improvement.
  • Collects information through data collection, observations, surveys, interviews, etc., to analyze the process.
  • Develops metrics for success and collaborative approach to design improvement.
  • Implements PDCA and LEAN tools as indicated to refine, measure, revise, and sustain improved processes in UR.
  • Monitors select measures for oversight committees and prepares timely reports.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
  • Attends and participates in department meetings and is accountable for all information shared.
  • Completes mandatory education, annual competencies and department specific education within established timeframes.
  • Completes annual employee health requirements within established timeframes.
  • Maintains license/certification, registration in good standing throughout fiscal year.
  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
  • Adheres to regulatory agency requirements, survey process and compliance.
  • Complies with established organization and department policies.
  • Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
  • Leverage innovation everywhere.
  • Cultivate human talent.
  • Embrace performance improvement.
  • Build greatness through accountability.
  • Use information to improve and advance.
  • Communicate clearly and continuously.

Education and Experience
  • The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Bachelor of Science in Nursing degree and current license to practice as a Registered Nurse in Indiana. A Master's degree in Nursing or advanced degree is preferred. Two years of recent utilization review/case management experience is required.

Knowledge & Skills
  • Demonstrates comprehensive knowledge of current training and adult education philosophies, techniques, programs, tools and equipment.
  • Demonstrates comprehensive knowledge of and competency in performing utilization review/case management functions.
  • Demonstrates critical thinking and analytical skills necessary to conduct training needs analysis, design programs, identify variances in standards of care.
  • Demonstrates ability to teach staff with a variety of educational backgrounds.
  • Demonstrates leadership skills necessary to coordinate activities and motivate all levels of staff.
  • Demonstrates initiative and high interest in teaching others.
  • Demonstrates well-developed interpersonal skills necessary to interface effectively with all levels of staff and customers and to conduct group and individual instruction.
  • Demonstrates well-developed communication skills, both verbal and written, necessary to communicate in an articulate and effective manner in front of groups. Relates to and provides effective feedback to the learner in a manner that is patient, constructive and enhances self-esteem.
  • Requires fundamental knowledge of the revenue cycle process, which includes such things as patient access, utilization review, charge capture, HIM and patient accounting.

Working Conditions
  • Works in a face paced environment requiring frequent changes in job demands.
  • May be exposed to bio-hazards.
  • Skillful in use of information technology including Excel, PowerPoint, Word and software tools.

Physical Demands
  • Requires the physical ability and stamina to perform the essential functions of the position.

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