Remote Medicaid Ops Specialist III-Epic Utilization Review
$30 - $45 per hourPyramid Consulting, Inc
- Remote job
A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This position is remote and offers a pay range of $30-$45 per hour with various employee benefits including health insurance and a 401(k) plan. #J-18808-Ljbffr Pyramid Consulting, Inc
$30 - $45 per hour
...is seeking an Operations Specialist III for a contract opportunity... ...role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will... ...metrics. This position is remote and offers a pay range of...Remote workEpicHourly payContract work$30 - $45 per hour
...Immediate need for a talented Operations Specialist III – Medicaid / Medi-Cal (Epic + Utilization Review. This is a 06+months contract opportunity with long-term potential and is located in Long Beach , CA(Remote). Please review the job description below and contact...Remote workEpicContract workLocal areaImmediate start- ...Description - Coding Specialist III (250000US) UT Southwestern... ...Experience — Epic electronic health record... ...Performs accurate and timely review of complex coding and... ...of UTSW accounts utilizing ICD-10-CM, HCPCS, and... ...procedures to include the Remote Coding Agreement where...Remote workEpicFull timeLive inWork from homeMonday to FridayFlexible hoursShift work
- ...Experience Required - Remote work for TX, AR, WI and... ...purpose of the Coding Specialist III is to code and verify... ...reimbursement (Medicare and Medicaid) principles.... ...CAC). Knowledge of Epic EHR and 3M 360 coding... ...% accuracy on quality reviews and meet assigned productivity...Remote workEpicContract workLocal area
$28.72 - $36.92 per hour
...position is primarily remote, candidates must reside... ...: The AR Follow-Up Specialist III, Coding and Complex... ...requiring advanced coding review to appropriate CPCs or... ...HMOs, PPOs, Medicare, Medicaid and compliance program... ...etc.) Experience in Epic and or other...Remote jobEpicHourly payFull timeWork at officeLocal area- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines....Remote work
- ...patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities...Remote workPart time
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels... ...candidates without this will not be considered. Proficient in Epic, with recent use within the last 6–12 months. Experience...Remote workEpic
- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift:... ...campuses Scrub Color: Any (no reddish orange permitted) Charting: EPIC Parking Cost: Facility PaidRemote workEpicLocal areaImmediate startMonday to FridayShift workWeekend work- ...Seeking a confident and detail-oriented Utilization Review Specialist, the full-time remote position will involve reviewing clinical documentation, managing insurance authorizations, and collaborating with providers to ensure timely care for clients in a behavioral health...Remote workFull time
- ...Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a liaison between clinical operations...Remote workFull time
$24.65 - $30.03 per hour
...team! Responsibilities The Utilization review tech essentially works to... ...CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific...Remote workFull timeWork at officeLocal areaShift work- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with...Remote work
$50k
...the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...Remote work- ...and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The... ...requiring clinical expertise and knowledge of Medicaid guidelines. Candidates must have an... ...setting, and the ability to work in a remote environment. Comprehensive benefits are...Remote workContract workWork from home
- ...Assurance, and JHM Compliance to include review of documentation and revenue cycle performance... ...all coding and billing changes. Approved Remote Locations: Maryland, Virginia, Washington... ...of third party payer issues. Preferred EPIC experience. Salary Range: Minimum 22.33/...Remote workEpicWork experience placementWork at office
$41.6k - $47k
...Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR... ...to stay organized and productive in a remote, independent work environment Proactive... ...healthcare programs (e.g., Medicare/Medicaid) PREFERRED QUALIFICATIONS ~1+...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work$16.74 - $26.92 per hour
...Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services including... ...time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...in. The Certified Coding Specialist working in our Ob/Gyn Department is responsible for reviewing medical documentation provided... ...Houston Ob/Gyn Revenue Cycle - Remote (following in person training)... ...Accountabilities: Resolves Epic Coding and Optum Claims...Remote workEpicFull timeFor contractorsWork at office
- ...employers, and Medicare and Medicaid members. SHP operates a portfolio... ...Together. This is a remote position in which we are able... ...following experience: Health plan utilization management Medicare and... ...(e.g., MS Office, EPIC, Clinical Care Advanced)....Remote workEpic
- ...seeking an experienced Health Informatics Specialist III to support enterprise level clinical and... ...is virtual care, including telehealth, remote patient monitoring, workflow redesign,... ...ancillary services, scheduling/throughput) • Epic experience • Ambulatory + pediatric...Remote workEpic
- ...This is a great opportunity for a local remote position. Schedule PRN (As needed... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing hospital admissions... ...after receiving the job offer. ~ EPIC experience is a plus! Overview...Remote workEpicReliefLocal areaWork from homeMonday to FridayFlexible hoursShift work
- ...healthcare practice, the contract-to-hire BCBA Licensed Utilization Review Specialist will perform prospective, concurrent, and retrospective reviews... ...medical necessity and appropriateness while working remotely. Key responsibilities Perform reviews to determine authorization...Remote workContract work
$22 - $26 per hour
...Accounts Billing Specialist At STRIDE Community... ...: Hybrid: 2 days remote, 3 days onsite at... ...aged receivables utilizing A/R reports/functionality... ...(RCM) module Review and assess... ...depth knowledge of Medicaid, Medicare and other... ...of the Job: Epic EHR Revenue Cycle...Remote workEpicHourly payLocal areaRelocationMonday to FridayFlexible hours$29.62 - $45.31 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...requests, customer service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for candidates...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...Construction Methods Specialist III | Providence, Rhode Island, United... ...This role is hybrid ( blend of remote, in office and in field work... ...benchmarking against peer utilities to ensure continuous improvement... .... 2. Coordinate the review of new or revised documents,...Remote workWork at office
- ...NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals and service authorization needs to ensure medical necessity aligns with CMS standards and organizational determinations. The role requires...Remote work
- ...mentorship and internal mobility Job Summary: Conduct reviews of physician documentation to identify opportunity for... ...requirements Facilitates clinical documentation Competent utilization of EPIC, 3M Encompass/CDIS, Midas Identify opportunities for operational...Remote workEpicReliefFlexible hours
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