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Work From Home Utilization Review Jobs in Madison, WI

The Semler Agency

Work From Home Sales

Madison, WI · On-site +1

This role is designed for individuals looking to learn a new skill and work from home with support. Responsibilities: * Connect with individuals requesting information * Provide guidance on coverage ...

HMG Careers

Work From Home Sales Specialist

Ridgeway, WI · Remote

$69K/yr

Remote, work-from-home career * Average first-year earnings of $69K through commissions and bonuses * Increased earning potential in later years through performance and renewals * Residual income ...

HMG Careers

Work From Home Sales Specialist

Lodi, WI · Remote

$69K/yr

Remote, work-from-home career * Average first-year earnings of $69K through commissions and bonuses * Increased earning potential in later years through performance and renewals * Residual income ...

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All JobsUtilization Review JobsWork From Home Utilization Review JobsWork From Home Utilization Review Jobs in Madison, WI

Work From Home Utilization Review information

See Madison, WI salary details

$15

$32

$54

How much do work from home utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for work from home utilization review in Madison, WI is $32.18, according to ZipRecruiter salary data. Most workers in this role earn between $22.55 and $40.91 per hour, depending on experience, location, and employer.

What is a work from home utilization review?

A Work From Home Utilization Review job involves evaluating the necessity, appropriateness, and efficiency of medical services provided to patients, typically for insurance companies or healthcare organizations. Employees in this role review patient records, treatment plans, and medical claims to ensure compliance with established guidelines and standards. Working remotely, these professionals often communicate with healthcare providers, patients, and insurance representatives to gather information and make recommendations regarding coverage or continued care.

What are some common challenges faced by work from home utilization review professionals, and how can they be managed?

Work From Home Utilization Review professionals often face challenges such as maintaining effective communication with healthcare providers and team members, managing time efficiently without in-person supervision, and navigating multiple electronic health record systems remotely. To manage these challenges, it’s important to establish clear communication channels, set structured daily routines, and stay updated with technology training. Many organizations offer virtual team meetings and resources to support remote collaboration and continuous professional development.

What are the key skills and qualifications needed to thrive as a work from home utilization review nurse, and why are they important?

To thrive as a Work From Home Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ) are often required. Exceptional communication, critical thinking, and time management skills help in effectively coordinating care and interacting with patients and providers remotely. These skills ensure accurate and efficient reviews, compliance with guidelines, and optimal patient outcomes while working independently.

What is the difference between Work From Home Utilization Review vs Work From Home Medical Coder?

AspectWork From Home Utilization ReviewWork From Home Medical Coder
CredentialsTypically requires healthcare-related certifications, such as RN, LPN, or medical reviewer credentialsRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentRemote, often involves reviewing medical records and insurance claimsRemote, involves reviewing and assigning medical codes to patient records
Industry UsageCommon in insurance, healthcare administration, and utilization managementCommon in medical billing, coding, and healthcare documentation

Work From Home Utilization Review and Work From Home Medical Coder roles both operate remotely within the healthcare industry. While utilization reviewers focus on assessing the necessity of medical services, medical coders assign standardized codes to patient records. Both require healthcare-related certifications and are essential for healthcare administration, but they differ in daily tasks and specific credentials.

What are popular job titles related to Work From Home Utilization Review jobs in Madison, WI?

For Work From Home Utilization Review jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Work From Home Utilization Review jobs in Madison, WI look for?

The top searched job categories for Work From Home Utilization Review jobs in Madison, WI are:

What cities near Madison, WI are hiring for Work From Home Utilization Review jobs?

Cities near Madison, WI with the most Work From Home Utilization Review job openings:

Work From Home Utilization Review jobs near you
Infographic showing various Work From Home Utilization Review job openings in Madison, WI as of June 2026, with employment types broken down into 1% Internship, 2% As Needed, 65% Full Time, 15% Part Time, 3% Temporary, and 14% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $66,943 per year, or $32.2 per hour.

Work From Home Sales

The Semler Agency

Madison, WI • On-site, Remote

Full-time

Re-posted 3 days ago

Job description

We are currently hiring for a remote sales position with a structured training program.
This role is designed for individuals looking to learn a new skill and work from home with support.
Responsibilities:
  • Connect with individuals requesting information
  • Provide guidance on coverage options
  • Follow a simple, structured process
What You'll Get:
  • Guided training program
  • Support from experienced mentors
  • Flexible scheduling
  • Performance-based income

No experience required - we will teach you everything you need to know.
After applying, you will receive an email with next steps to schedule a quick overview call. Please keep an eye out for a text from Terra after applying.
*NOTE: Equal opportunity, not equal outcome. No agent's success, earnings, or production results should be viewed as typical, average or expected. Not all agents achieve the same or similar results, and no particular results are guaranteed. Your level of success will be determined by several factors, including the amount of work you put in, your ability to successfully follow and implement our training and sales system and engage with our lead system, and the Insurance needs of the customers in the geographic areas in which you choose to work.

Apply