Healthcare Utilization Review Specialist
$20 - $30 per hourGuidelight Health
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include conducting live reviews, coordinating with clinical teams, and ensuring compliance with regulations. The position offers a pay range of $20 - $30 USD, along with comprehensive benefits including medical, dental, and professional development opportunities. #J-18808-Ljbffr
$39.4 - $53 per hour
...healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should... ...Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job function include:...SuggestedTemporary workWork at officeLocal areaRemote workMonday to FridayWeekend work$80 per hour
...are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization workflows, documentation review, and...SuggestedHourly payPart timeFor contractorsWork at officeRemote workFlexible hours$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50,000 per year,... ...Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary...SuggestedRemote work- Allegheny Health Network is seeking a Utilization Review Support position to manage insurance verification, authorizations, payer communications, and follow-up. This role supports utilization review nurses to ensure proper documentation and payment authorization for transfers...Suggested
- ...Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role requires interpreting criteria and policies with independent...Suggested
- ...related Streaming Services. Standards & Practices Associates review high profile national advertising campaigns to ensure... ...communication, claim support, and other documentation obtained and utilized in the clearance process is an integral part of this role. The...Contract workFixed term contractWork at officeRemote work
$32.85 - $35.71 per hour
Broadcast Standards & Practices Associate / Ad Review Specialist 2 days ago Be among the first 25 applicants Get AI-powered advice on this... ..., claim support, and other documentation obtained and utilized in the clearance process is an integral part of this role....Fixed term contract$76k - $199.6k
...maintain customer engagement by successfully utilizing existing and ever-changing digital tools... ...and/or Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist,... ...public disclosure. Subject to further legal review and statutory or regulatory...Permanent employmentFull timeH1bLocal areaRemote workVisa sponsorshipWork visaRelocation package- ...provides the highest quality healthcare services to residents of... ...000 primary care providers, specialists and participating clinics. For... ...worker is unavailable. Utilize the personal lived experience... ...Treatment/Recovery Plans will be reviewed and signed by Team Leader...Work at officeLocal areaTrial period
- ...FHE Health is seeking an experienced UR Specialist to manage clinical authorizations with insurers, ensuring timely communication and adherence to payer guidelines. You will support patient access by securing initial and continued authorizations and collaborating with...Remote work
- ...PAHub & Prior Authorization Specialist serves as a trusted consultant... ...calls, workshops, business reviews, and operational meetings.... ...Optimization Assess customer utilization of PAHub and identify opportunities... ...5+ years of experience in healthcare operations, prior...Local areaRemote work
$10k
...dramatically expanding access to healthcare by reimagining the patient... .... As a Patient Engagement Specialist I, you are often the first... ...Specialist I Your day will begin by reviewing and following up on inbound... ...Throughout the day you will utilize deep prospecting techniques...Flexible hours- ...Cycle Management solutions for healthcare organizations, leveraging... ...Position Summary The Revenue Specialist, Commercial Billing... ...Research, request, acquire, and review medical records, provider notes... ...knowledge of account information. Utilizing information to manage claim...Remote jobFlexible hours
- ...currently seeking a Patient Support Specialist to join our team. The... ...the appointment time, reviewing, and verifying demographics,... ...helping others navigate their healthcare journey, we want to hear from... ...provider time, and treatment room utilization by scheduling appointments...Work at officeLocal areaImmediate start
$15.92 - $19.44 per hour
...data collaboration platform trusted for healthcare. Guided by our mission to make the world... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other... ...from these requirements will be reviewed by Datavant Human Resources and determined...Hourly payFull timeWork experience placementWork at officeMonday to Friday- ...concurrent, retrospective, and Medicare reviews to determine medical necessity and... ...and support concurrent and retrospective utilization reviews Identify quality concerns, report... ...or Case Management experience within a healthcare system or insurance organization...
$15 - $18.32 per hour
...data collaboration platform trusted for healthcare. Guided by our mission to make the world... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other... ...exempted from these requirements will be reviewed by Datavant Human Resources and...Hourly payFull timeTemporary workWork experience placementWork at officeMonday to Friday$57.7k
...care, helps members to coordinate their healthcare services and navigate the healthcare system... ...telephonic contact with each member to review progress and assess the potential for... ...Management Certification Skills Proficiency in utilizing PC‑based system application and...Remote jobTemporary workFor contractorsWork at officeLocal area$23.1 per hour
...We are currently seeking a Health Care Specialist (HCS) to work full-time at our Bay Ridge... ...direct care staff. Conducts timely reviews of anecdotals and presents questions to... ...Basic computer skills – including email, utilizing Workday and related systems (DA, etc.) to...Full time$18.92 - $23.46 per hour
...“Best Place to Work Modern Healthcare” - Join a team where people... ...Summary: The Payment Posting Specialist will work in a team-based environment... ...problems from documentation review, determine lasting solutions... ...knowledge and skill in utilizing the MS Office suite of...Full timeTemporary workLocal areaImmediate startFlexible hours- ...continually strive to be the healthcare leader in quality,... ...experience? JOB SUMMARY: The Coding Specialist operates as a member of the... ...DUTIES AND RESPONSIBILITIES: Reviews medical records to assign accurate... ...level of service selection. Utilizes coding software, encoder and...Temporary workMonday to Friday
$78.2k - $121.2k
...Lead Professional Affairs Specialist The Professional Affairs function... ...and execution of healthcare professional (HCP) engagements... ...educational activities. Review invoices and supporting documentation... ...Comfortable learning and utilizing business systems, databases,...Temporary workWork experience placementWork at officeLocal areaImmediate start- ...About Amperos Amperos is healthcare's first AI-native denial management and revenue recovery... ...for a Senior Accounts Receivable Specialist to join our client onboarding team — a small... ...detail to act on immediately Conduct QA reviews of permanent BA work during the...Permanent employmentFull timeWork at officeImmediate startFlexible hours
$72.5k - $154.3k
Marsh is seeking candidates to join our Healthcare Placement team focused on medical professional liability based in our New York or Chicago... ...production such as active participation in RFPs and coverage reviews Coverage expertise to be able neg and drive optimal terms on...Minimum wageWork at officeLocal areaRemote workFlexible hours3 days per week1 day per week- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote... ...experience in clinical practice and knowledge of Utilization Review Guidelines. The position offers a...Remote work
$42 per hour
...Medicare Annual Wellness Visit Specialist - PRN Full-time WHO IS... ...powered, performance-driven healthcare company dedicated to operational... ...are completed. Virtually reviewing and updating patient medical... ...factors for chronic diseases, utilizing remote monitoring tools when...Bi-weekly payFull timeTemporary workFor contractorsReliefLocal areaRemote workWork from homeMonday to Friday- ...Associate Vice President, Space Planning & Utilization About the Company Acclaimed clinical research & medical care center Industry... ...Databases Specialties medicine education healthcare science and biomedical research Business Classifications...
$120k - $125k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...outcomes. Join Medtronic as an EP Mapping Specialist and be at the forefront of transforming... ...addition, your driving record will be reviewed and will be considered as part of your...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift- ...GroupAt CMI Media Group, we are delivering healthcare marketing at the speed of life. Our... ...looking for a proactive, detail-oriented Specialist, Audit & Compliance to join our team. In... ...and track PBC (Provided by Client) lists, review submissions for completeness, and manage...Flexible hours1 day per week
$135k - $140k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...addition, your driving record will be reviewed and will be considered as part of your... ...infectious disease and radiation Clinical Specialists are required to be within their assigned...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift
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