Remote Medicaid Ops Specialist III-Epic Utilization Review
$30 - $45 per hourPyramid Consulting, Inc.
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
$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- ...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
...AR Follow-Up Specialist III, Coding and Complex Denials The AR Follow... ...cases requiring advanced coding review to appropriate CPCs or... ...forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations... ...-mail, etc.) Experience in Epic and or other electronic billing...Remote jobEpicHourly payFull timeLocal area$50k - $60k
...application process. RCM Specialist III Regular Full-Time Professional Remote, US Salary Range: $50,0... ...via paper as needed. Review claims for accuracy and... ...working with Medicare, Medicaid, and commercial insurance... ...Medical Record (EMR) system. EPIC experience and/or...Remote workEpicFull time- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years... ...compliance with CMS, Medicare, Medicaid, Joint Commission, and other regulatory... ...payer audits.Familiarity with Epic, Cerner, Meditech, or other...Remote workEpicFull timeSecond jobWork at office
- ...Coding Specialist III With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern... .... Exercises independent judgment in the review of encounters characterized by high... ...encounter documentation within Epic to ensure accurate and compliant documentation...Remote workEpicFull timeLive inWork at officeWork from homeMonday 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
- ...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
- ...Job Description: The Utilization Review Specialist nurse (UR RN) is responsible for monitoring adherence to the Utilization Review Plan (UR Plan... ...On-site required Must be proficient in in both EPIC and InterQual programs Position Urgency: Normal...EpicContract workMonday to FridayFlexible hoursShift workWeekend work
$28.72 - $36.92 per hour
...Authorization Specialist III The 61st Street Service Corporation, provides... ...This position is primarily remote, candidates must reside in... ...demographic information. Reviews clinical documentation to ensure... ...preferred. Experience in Epic and or other of electronic billing...Remote jobEpicHourly payFull timeWork at officeLocal areaImmediate start- ...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
$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- ...To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client...Remote workFull timeWork at office
- ...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
$2,065 per week
...Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers... ...Utilization Review Extension (UR EXT) specialist for a remote position. This role involves... ...Electronic Medical Records (EMR) such as Epic, and utilization management tools like...Remote workEpicTemporary workFor contractorsZero hours contractMonday to FridayShift workWeekend work$24.65 - $30.03 per hour
...! Responsibilities The Utilization review tech essentially works to coordinate... ..., 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$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...Remote work$2,400 per week
...of Miami is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers,... ...accommodate time off during Christmas Week. REMOTE POSITION Utilization Management:... ...only payers. CCM/CMCN required. EMR: Epic experience required & UM tool is...Remote workEpicDaily paidPermanent employmentContract workTemporary workFor contractorsZero hours contractWorldwideMonday to FridayShift workWeekend work- ...Utilization Review Specialist Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing... ...is seeking a full-time Utilization Review Specialist (REMOTE) to play a key role in ensuring the efficient, accurate, and...Remote workFull timeWork at office
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical information and obtain authorizations for ABA and related services. This role supports remote or office/home hybrid work and emphasizes attention to medical necessity and HIPAA...Remote jobWork at officeWork from home
$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 workPermanent employment2 days per week$62k - $70k
...of this position is to ensure that the utilization process is thorough, organized and streamlined... ...timely manner Completes peer to peer reviews with insurance MDs to advocate for... ...Charlie Health-sponsored benefits. #LI-REMOTE Please note that this role is not available...Remote workFull timeLocal area- ...Utilization Review Specialist Remote, United States About the Role The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the complex nature...Remote work
- ...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
$35 - $40 per hour
...Location: Remote Schedule: Monday-Friday 8am-5pm MST Compensation: $35-40/hour Northpoint Recovery Holdings, LLC began 200... ...POSITION SUMMARY: As a key member of the Northpoint team, the Utilization Review Specialist is a licensed professional who is responsible for ensuring...Remote workFull timeTemporary workWork at officeMonday to Friday- ...Exeter, NH/ South Burlington, VT/ Hybrid/ Remote Employment Status: Full-time FLSA Status: Non-Exempt Reports To: Utilization Review Process Manager Job Summary: Under the supervision... ...Process Manager, the Utilization Review Specialist will use professional discretion and...Remote workFull timeWork at office
$55k - $70k
...Utilization Review Specialist (in-office only) Quadrant Health Group Boca Raton, Florida, United States About this position Quadrant Billing Solutions... ...position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be...Remote workFull timeWork at officeLocal area- ...Job Description Job Description Utilization Review Specialist Job Description Unique opportunity to join Maryhaven, Central Ohio’s largest and... ...Electronic Health Records. Must have LPCC, LSW, LCDC III or RN. Utilization Review Specialist Requirements...
$2,150 per week
...Cycle is seeking a travel nurse RN Remote Case Manager, Utilization Review for a travel nursing job in Minneapolis... ...and professional development specialist to develop standard work and expectations... ...Full-time, Days SYSTEMS Epic, InterQual START DATE ASAP...Remote workEpicPermanent employmentFull timeTemporary workFor contractorsWork at officeImmediate startShift work- ...Details POSITION SUMMARY - RN Utilization Review POSITION DUTIES - Review... ...hospital-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT - 1... ...weekend rotation SYSTEMS - Epic, Dragonfly - DragonFly experience is required...Remote workEpicTemporary workShift workWeekend work
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