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
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 me...Remote workEpicContract workLocal areaImmediate start- ...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
- ...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
- ...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
- ...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 At Umpqua Health, we're more than a healthcare organization we're a community... ...stay organized and productive in a remote, independent work environment... ...healthcare programs (e.g., Medicare/Medicaid) Preferred Qualifications: ~1+ years...Remote workWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work- ...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
- ...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
- ...this role? The Revenue Cycle Specialist III works under general supervision... ...assessment of charge review. Inputs specialty or cosmetic... ...documentation of appeal activity in Epic, ensuring compliance with... ...audit readiness. *Approved Remote States: Arizona, California,...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
$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- Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...Remote job
- Diversified Treatment Alternative Centers is looking for a Utilization Review Specialist in Chadds Ford, PA. This role supports behavioral health... ...case management. This position offers flexible hybrid or remote work options and a comprehensive benefits package. #J-188...Remote jobFlexible hours
- ...assigned tasks related to preadmission reviews, continued stay reviews, medical necessity... ..., in the least restrictive environment, utilizing proven clinical interventions will lead... .... Seeks guidance from appropriate leadership when facility #J-18808-Ljbffr Remote JobsRemote workWork at office
- 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 jobContract workWork from home
- Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR)...Remote workFull timeMonday to FridayFlexible hours
$50k
...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 reviews...Remote job$55k - $70k
Utilization Review Specialist ? Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are? Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental...Remote workFlexible hours- ...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
- ...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
- ...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
- ...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
- ...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
$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- Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote job
- HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role... ...and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr...Remote job
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity, coordinate with physician advisors, and collaborate with care management and financial clearance teams to ensure high-quality patient care and appropriate...Remote job
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