Remote Utilization Management Specialist Payer Authorization
Cedars-Sinai Medical Center
Cedars-Sinai is seeking a highly organized Utilization Management Specialist to provide advanced operational and workflow support for UR Nurses, ensuring timely, accurate, and compliant utilization review processes. You will manage authorization lifecycles, coordinate with payers, and maintain documentation in EPIC/CS-Link and related UM systems.
In a fast-paced environment, you will prioritize cases by deadlines and regulatory requirements, escalate issues to prevent denials, and collaborate
#J-18808-Ljbffr- Cedars-Sinai seeks a detail-oriented Utilization Management Specialist to support UR Nurses in advancing timely and compliant utilization review activities. You will manage authorization workflows, coordinate with payers, and ensure documentation accuracy in EPIC/CS-Link...Remote job
$53.19k - $82.43k
...Will Do in This Role: The Utilization Management Specialist provides advanced operational and... ...functions that directly support payer communication, authorization coordination, documentation integrity... ...and complete. *Approved Remote States: Arizona, California,...Remote workFull time- ...Cedars-Sinai in Phoenix, AZ seeks an experienced Authorization Specialist to manage a caseload in collaboration with UR Nurses and ensure timely utilization review and payer submissions. You will assemble clinical review packets, track determinations, monitor payer...Remote work
$26 per hour
...provider of Revenue Cycle Management (RCM) and Risk... ...Responsibilities The Authorization Representative will need... ...and managed care payers. Verify patient eligibility... ...payer audits and utilization management reviews by... ...26 - 26 USD per hour(Remote (United States)) #J-1...Remote workHourly pay$37.5 - $54.25 per hour
...Health is searching for a Utilization Management Specialist to join our dedicated team... ...-centered care! Fully remote opportunity - Must currently... ...partners to facilitate authorizations and medical necessity reviews... ..., and responds to payer inquiries in a professional...Remote workFull timeImmediate start10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift- Cedars-Sinai seeks a detail-oriented Utilization Management Specialist to support UR Nurses and manage the authorization lifecycle using EPIC/CS-Link. You will ensure timely,... ...accurate documentation and compliance with CMS and payer requirements, collaborating with Case...Remote job
- ...leading revenue cycle management services for... ...We are seeking a ABA Utilization Review Specialist The ABA Utilization... ...initial and continuing authorizations for ABA and related... ...environment. This is a fully remote or office/home... ...clients in understanding payer requirements for...Remote workWork at officeFlexible hours
- ...Managing insurance authorizations for mental health and substance use treatment... ...time Behavioral Health Utilization Review Specialist will verify benefits, complete... ...criteria while working remotely. Key responsibilities... ...with insurance payers and managed care organizations...Remote workFull time
$90.9k - $129.9k
...adjudicate Behavioral Health prior authorizations based on medical necessity... ..., rather you will provide utilization review and quality assurance... ...outcomes into the Medicaid Management Information System (MMIS)... ...expect in this role ~100% Remote home office. ~ Full-time position...Remote workFull timeWork experience placementHome officeFlexible hours- ~ Submits, tracks, and manages prior authorization requests for medical and ancillary... ...providers, and insurance payers to file appeals or... ...prior authorization related utilization trends, claim denials, denial... ...as a Prior Authorization Specialist, with expertise in medical...Remote workWork at office
- Cedars-Sinai in Los Angeles seeks a focused Utilization Management Specialist to provide advanced operational support to Utilization Review nurses,... ...assigned case portfolio, prepare submission packets, monitor payer timelines, escalate gaps, and coordinate with Case...Remote job
- ...Logan Health is seeking a Utilization Management Specialist to join our team in a fully remote role focused on inpatient admissions reviews, physician documentation assessment, and authorizations across the Logan Health system. The position emphasizes collaboration with...Remote work
- ...Group is seeking a Licensed Speech-Language Pathologist for a fully remote Utilization Specialty Therapist role. This 9-month contract focuses on clinical utilization review and therapy prior authorization, with a Monday-Friday schedule. Responsibilities include reviewing...Remote jobContract workMonday to Friday
$27 - $30 per hour
...environment, and have experience in utilization management, healthcare insurance, or pharmacy operations, this remote opportunity offers a chance to... ...Matters As a Utilization Management Specialist, you'll play a key role in the authorization review process, helping ensure...Remote workContract workMonday to Friday- ...October 27, 2026 Full-Time Remote Locations Showing 1... ...Texas Wyoming The Utilization Review Specialist assumes responsibility and... ...prevention of denials from all payers, as well as appeals of all... ...appeals. Consults with managers on problem cases and interfaces...Remote workFull time
$68.79k - $80.85k
...Title: Prior Authorization Specialist Reports to: Director, Pharmacy Operations Classification... ...Contributor Location: MA (Remote) Job description revision number and... ...organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs...Remote workFull time- ...is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on... ...and maintaining insurance authorizations, communicating with managed care organizations, and collaborating... ..., strong knowledge of payer requirements, excellent...Remote workPart timeWeekend work
- ...Description Job Description Utility Forester - Vegetation Management Specialist Position Summary Clear Path... ..., easements, and access authorization required to complete vegetation... ...hike long distances and work in remote locations. Ability to stand,...Remote workFor contractorsWork at officeLong distance
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications with insurance payers. You will support patient access by securing initial and continued...Remote work
- ...care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement through... ...to independently complete clinical review to obtain payor authorization. Demonstrates mastery in InterQual Level of Care Criteria...Remote jobTemporary workWork experience placementLive outFlexible hours
- ...are seeking an experienced specialist who is passionate about... ...You'll Do Responsible for managing all clinical authorization processes to ensure... ...communication with insurance payers. This role supports patient... ...preferred. 2-3 years of utilization review experience in behavioral...Remote workDaily paidFull time
$22 - $26 per hour
...review, submission, and follow up of prior authorizations. This role requires working knowledge... ...and supply, ensuring compliance with payer requirements and clinical guidelines.... ...requests accurately and in a timely manner, utilizing electronic submission platforms and...Remote workMonday to FridayShift work- ...Coronis Health is seeking a qualified Utilization Review Specialist to manage authorization of treatment with insurance and managed care companies from a remote Jackson, MI area. You will provide information to payers about medical necessity and perform pre-certification...Remote work
- ...behalf of a partner company, who manages all applications and next steps.... ...is looking for a Case Manager - Utilization Review Specialist based in the United States.... ...ensuring compliance with clinical and payer requirements. In this remote role, you will oversee admission...Remote workFull timeLive in
- ...Prior Authorizations Specialist CNC Management Solutions LLC West Lake Hills, Texas, United States About this position ABOUT THE CRANE CENTER... ...West Lake Hills, TX 78746 (Required) Work Location Hybrid remote in West Lake Hills, TX 78746 #J-18808-LjbffrRemote workFull timePrivate practiceWork at officeMonday to Friday
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing... ...Ford PA (Hybrid / Remote Eligible) Job Type:... ...necessary, appropriately authorized, and compliant with payer, state, and regulatory... ...Review Specialist manages the full lifecycle of...Remote workFull timeMonday to FridayFlexible hours
- ...Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation... ...judgment, and collaboration with providers and members, in a remote setting. Requirements include a nursing degree or a Human...Remote workWork at office
- ...UnityPoint Health is seeking a Referral and Authorization Coordinator - Infusion Services to manage new referrals, coordinate authorizations, and ensure timely... ...medical necessity, collaborate with providers and payers, and support appeals, financial assistance resources...Remote work
- ...Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related... .... This role offers either remote work or a home-office hybrid setup... ...reviews and compliance with payer requirements. Ideal candidates...Remote jobWork from homeHome office
- ...Description:Role Summary: The Authorization Specialist role is responsible... ...Patient Finance Manager in training staff,... ...necessary appeals.Review payer guidelines for... ...delivery skills.Ability to utilize websites, portal and... ...of the organization.#LI-REMOTE #J-18808-Ljbffr...Remote workWork at office
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