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Work From Home Utilization Review Jobs in Raleigh, NC

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Work From Home Utilization Review information

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$15

$31

$52

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

As of Jul 29, 2026, the average hourly pay for work from home utilization review in Raleigh, NC is $31.05, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $39.47 per hour, depending on experience, location, and employer.

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 a Work From Home Utilization Review job?

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 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 Raleigh, NC? For Work From Home Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Work From Home Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Work From Home Utilization Review jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Work From Home Utilization Review jobs? Cities near Raleigh, NC 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 Raleigh, NC as of July 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 100% Remote job distribution, with an average salary of $64,581 per year, or $31 per hour.

Work From Home - Enrollment Specialist

AO Garcia Agency

Durham, NC • On-site, Remote

Full-time

Posted 5 days ago

Job description

Are you looking for a work-from-home opportunity where you can grow with a company, help others, and uphold the highest standards of integrity? Are you passionate about making a positive impact on the lives of others? Look no further!
Seeking dedicated individuals to join a team in a financial services position aimed at protecting families.
Why Apply:
1. Make a Difference: Join a team dedicated to protecting families and children through financial services, providing peace of mind and security to those who need it most.
2. Work from Home: Enjoy the convenience and flexibility of working remotely, allowing you to create a comfortable and productive work environment while balancing your personal commitments.
3. Opportunity for Growth: Grow with a company that values your potential and provides opportunities for advancement, allowing you to build a rewarding career while making a meaningful difference in the lives of others.
4. Help Others: Use your skills and expertise to assist families in securing their financial futures, providing them with the support and guidance they need to navigate life's uncertainties with confidence.
5. Integrity: Uphold the highest standards of integrity in all aspects of your work, ensuring that every interaction with clients is based on honesty, transparency, and trust worthiness.
Qualifications:
• Genuine desire to help others and make a positive impact on their lives.
• Strong communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Integrity and ethical conduct in all professional dealings.
If you're ready to embark on a fulfilling career where you can work from home, help others, and grow with a company that values integrity and compassion, apply now! Take the first step towards a rewarding journey of making a difference in the lives of families and children through financial services.
Don't miss out on this opportunity to join a team that's committed to making a meaningful impact. Apply today and become part of a mission to protect and support families and children in need!
*All interviews will be conducted via Zoom video conferencing.
(Global Elite Empire Consultants is a third-party recruiter, not an insurance agency)
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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