Remote Utilization Review Specialist - Healthcare
Coronis Health
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 and concurrent reviews.
You will liaise with hospitals and providers, ensure compliance with state and federal regulations, maintain patient confidentiality, and participate in audits.
#J-18808-Ljbffr$30 - $45 per hour
A leading healthcare consulting agency is seeking an Operations Specialist III for a contract opportunity in Long Beach, CA... ...with experience in Epic EHR and Utilization Review. The selected candidate will... ...metrics. This position is remote and offers a pay range of $30...Remote workHourly payContract work- ...is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...For We are seeking an experienced specialist who is passionate about making a... ...field required preferred. 2-3 years of utilization review experience in behavioral health, addiction...Remote workDaily paidFull time
$90.9k - $129.9k
...powerful solutions that solve some of healthcare’s most complex challenges. Join us and... ...for this role, rather you will provide utilization review and quality assurance. Your role in... ...should expect in this role ~100% Remote home office. ~ Full-time position....Remote workFull timeWork experience placementHome officeFlexible hours- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...years in utilization review or related fields, and proficiency with Microsoft Office and healthcare software. #J-18808-LjbffrRemote workWork at office
$60k - $70k
...process. Full Time Office/Clerical Remote, Birmingham, AL, US Salary Range:... ...where they are. Bradford is more than a healthcare network; we are recovery communities... ...of the journey. We are seeking a Utilization Review Specialist to add to our dynamic team! The...Remote workFull timePart timeWork at office- EK Health Services Inc. is hiring for a Utilization Review healthcare professional in a remote, full-time capacity. The UR HCP applies clinical knowledge to assess the medical necessity of provider requests and uses evidence-based guidelines appropriate to the jurisdiction...Remote jobFull time
- ...revenue cycle management services for healthcare providers. Our team has deep industry... ...manner. We are seeking a ABA Utilization Review Specialist The ABA Utilization Review Specialist... ...rewarding environment. This is a fully remote or office/home hybrid position. Your...Remote workWork at officeFlexible hours
- ...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
- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote workFull time- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care. The role collaborates with Admitting, Financial...Remote work
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with...Remote workMonday to FridayWeekend workWeekday work- ...Delivery System (DMC-ODS), including review of medical records to ensure proper utilization of treatment resources and... ...behavioral health treatment. UR Specialists also interpret, advise and train... ...eligible list. The option for hybrid remote work may be available based on...Remote workContract workLocal areaTrial periodFlexible hours
- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Remote workPart timeWeekend work
$34.82k - $55.99k
...The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion... ...Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
- ...and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and support medical necessity criteria while working remotely. Key responsibilities Verify insurance benefits, eligibility,...Remote workFull time
$18 - $20 per hour
...compassionate professional to join our Utilization Review department. At Camber,... ...As a Utilization Review Specialist, you serve as the vital... ...corporate office, 3 days remote. What You Will Do Act... ...of medical terminology and healthcare regulations. Analytical...Remote workHourly payFull timeWork at office- ...As Utilization Review Specialists, we are the liaisons between insurance payors and the treatment facilities we service, advocating for clients to... ...personally represented as "recovering". Benefits ~100% remote first company to foster flexibility, inclusivity, and...Remote workFull timeWork at office
- ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday – Friday Diversified... ...: Bachelor's degree in Healthcare Administration, Nursing, Social Work...Remote workFull timeMonday to FridayFlexible hours
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
$63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt Unit : UAW Department/Location : Utilization Management... ...requirements for this position. While the position is remote, the individual in this position will have occasional travel...Remote workFull timeTemporary workMonday to Friday- ...an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/... ...Degree in Nursing. BSN preferred; healthcare experience with managed care and utilization...Remote workWork from homeWeekend workAfternoon shift
$63.1k - $83.65k
...making a difference by helping others. We are seeking a Utilization Review Specialist to perform utilization review of intellectual and... ...holiday requirements for this position. While the position is remote, the individual in this position will have occasional travel...Remote workFull timeTemporary workMonday to Friday- ...Praesum Healthcare, founded in 2003, provides administrative services for behavioral health facilities in the Northeast, mid... ...and mental health outpatient clinics. Position Title: Utilization Review Specialist Responsibilities Initiate pre‑certification and continued...Full timeWork at officeVisa sponsorshipWeekend work
- ...Layfette, IN and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities... ...milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions...Full timeLocal area
- ...South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in... ...admission and concurrent stay medical record review to determine appropriateness of... ...related information with others. Utilizes the service recovery process to resolve...Full timeTemporary workWork at officeFlexible hours
- ...Evolve Treatment Centers in West Palm Beach, Florida, is seeking a full-time Utilization Review Specialist. This role involves initiating pre-certification authorizations, communicating with facilities, and maintaining patient census. Candidates should have a High School...Full time
$20 - $30 per hour
...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...- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist. The role supports review of clinical data to determine medical necessity... ...for ABA and related services. It is a fully remote or office/home hybrid position with a collaborative, detail...Remote jobWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review Specialist - Healthcare. Be the first to apply!
- cybersecurity specialist Jackson, MI
- gaming specialist Jackson, MI
- fabrication specialist Jackson, MI
- international relations specialist Jackson, MI
- executive protection specialist Jackson, MI
- adoption specialist Jackson, MI
- transportation specialist Jackson, MI
- drug safety specialist Jackson, MI
- wildlife specialist Jackson, MI
- continuous improvement specialist Jackson, MI



