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
$80 per hour
...experienced in prior authorization, utilization management, clinical review, medical necessity... ...current and upcoming remote consulting opportunities focused... ..., Medicare Advantage, Medicaid, and other payer authorization... ...and EHR platforms such as Epic, Cerner, or similar...Remote workEpicHourly payPart timeFor contractorsWork at officeFlexible hours- ...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
- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers... ...provider collaboration, and adherence to Medicaid contracts. Qualifications include a Bachelor...Remote workFull time
- ...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
- ...Utilization Review NurseWe are seeking a detail-oriented and experienced Utilization... ...with CMS, Medicare, Medicaid, Joint Commission, and other... ...audits. Familiarity with Epic, Cerner, Meditech, or other... ...utilization management department. Remote, hybrid, or on-site...Remote workEpicWork at office
- ...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
$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- ...RN Utilization Review Review patient medical records to assess the appropriateness and medical... ...hospital-based) ~ Skilled experience with remote work Length of assignment: 13... ...fifth weekend rotation Systems: Epic, Dragonfly - DragonFly experience is required...Remote workEpicShift workWeekend work
- ...Registered Nurse Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...candidates without this will not be considered. Proficient in Epic, with recent use within the last 612 months. Experience...Remote workEpic
- ...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
- ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry-leading revenue cycle... ...to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...rewarding environment. This is a fully remote or office/home hybrid position.Your Responsibilities...Remote workWork at officeFlexible hours
- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing...Remote workTemporary work
$70k - $100k
...of the Surgery Partners network, is seeking an experienced Utilization Review Specialist to join its team in Addison, Texas. This position is ideal... ...is a hybrid opportunity offering the flexibility of three remote workdays per week while maintaining an onsite presence two...Remote workContract work2 days per week$39.4 - $53 per hour
...Central Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job function include:... ...Knowledge, Skills, and Abilities Required: This is a remote role which requires access to high speed internet Excellent...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend work- ...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
- ...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
- ...Position is Remote-Must live in one of... ...purpose of the Coding Specialist II is to code and... ...responsible for charge review on clinic and... ...understanding the utilization of modifiers and other... .... *Knowledge of Epic EHR and 3M 360... ...Centers for Medicare & Medicaid Services (CMS)...Remote workEpicContract workLive inLocal area
- ...of appropriate clinical review of all applicable... ...patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains... .... This role will be remote BUT regular meetings/trainings... ...level of care using Epic and escalating cases...Remote workEpicReliefWeekend work3 days per week
$51 per hour
...Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote - offsite) Type: Contract To Hire Compensation: $51/hr (W2) Work Model: 100% Remote Must be Licensed in one of the 3 states: MD, VA or Washington D.C. Overview Utilizing...Remote workFull timeContract workWork at officeLocal areaWork from home- ...CARC/RARC denial codes, Epic denial work queues, and... ...across Medicare, Medicaid, and commercial payers.... ...Responsibilities Denial Review & Resolution – PB & HB... ...actions and resolutions. Utilize payer portals (Availity... ...and orderly remote work area. Meet specified...Remote workEpicWork experience placementLocal area
$65k - $85k
...Job Description Job Description Utilization Review Specialist (RN) – Remote $65K–$85K | OASIS & Coding Certified | Florida RN License Required Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home...Remote workMonday to FridayWeekday work- ...Utilization Management SpecialistThe Utilization Management Specialist demonstrates excellent customer service performance... ...requirements, payer reviews, contacts, decisions... ...the patient class in Epic (3 point match).All... ...Manages and responds to Medicaid denials of inpatient...EpicContract workWork at officeLocal areaImmediate start
$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$22.3 - $30.11 per hour
...- $30.11 Surgical Specialists - Remote/Hybrid-Redmond, Oregon... ...Varies DATE LAST REVIEWED: March 5, 2024 OUR... ...procedure schedule to EPIC procedure schedules.... ...user and is proficient utilizing snap board, case... ...guidelines including CMS, Medicaid, COBRA, EMTALA, HIPAA...Remote workEpicPart timeMonday to FridayShift workDay shift- ...Monday-Friday 8am-4:30pm Remote Summary: The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding... ..., Centers for Medicare & Medicaid Services, American Association... ...professional journals) # Reviews EPIC work queues daily for...Remote workEpicFull timeMonday to Friday
- ...SpecialistShift: M-Fr 8-5This is not a remote position. It is an office-based... ...The Role ItselfPosition Summary: The Utilization Review Specialist is responsible for the authorizations... ...organizations (ie: Medicare/Managed Care/Medicaid) with knowledge of payor resources and...Work at office
- ...Revenue Cycle Specialist III - Payment Poster Fully Remote ESP Executive Offices - Dallas, TX 75038 Payment Poster... ...the practice management system Review and reconcile EOBs (Explanation of... ...as directed by management Utilize various systems for payment posting...Remote workWeekly pay
- ...Utilization Review SpecialistParkside provides professional purpose, hope, and healing. As a member... ...for a Full Time Utilization Review Specialist! The Utilization Review Specialist... ...party pay sources including Medicare, Medicaid, HMO or private insurance. Coordinates...Full timeWork at officeImmediate startFlexible hours
- The HIMS Senior Specialist should have a broad knowledge... ...(EHR), specifically Epic. The individual should... ...health care documentation. Utilizes independent analytical... ...that is primarily remote. Candidates must reside... ...interview will be reviewed by a Mayo Clinic staff...Remote workEpicContract workWork at officeFlexible hours
$66.83k - $111.38k
...Days) Overview: Sentara Health Plans is hiring an Utilization Review Nurse/ RN for Medicaid - Remote! Status: Full-time, permanent position (40 hours)... ...features a robust provider network, including specialists, primary care physicians and hospitals. We offer...Remote workPermanent employmentFull timeTemporary workShift workDay shift
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