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
$31.4 - $36.06 per hour
Medical Biller Charge Review and Data Entry Specialist III Department: BILLING Location:... ...Minimum of 7 years’ experience Epic EMR experience strongly... ...Center for Medicare and Medicaid Services (CMS) for... ...effectively, and professionally. Remote/hybrid options are...Remote workEpicHourly payFull timeTemporary workWork at office- ...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
- ...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
...position is primarily remote, candidates must reside... ...: The AR Follow-Up Specialist III, Coding and Complex... ...requiring advanced coding review to appropriate CPCs or... ...HMOs, PPOs, Medicare, Medicaid and compliance program... ...etc.) Experience in Epic and or other...Remote jobEpicHourly payFull timeWork at officeLocal area- ...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
- ...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
- ...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
- ...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
- ...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 Start Date: 08/03/2026...Remote workEpicShift workWeekend work
- ...Partners is seeking a dedicated RN for a Utilization Review & Quality Improvement role at a... ...assist in the transition from Empower to Epic following an acquisition. The team includes... ...position follows a 4x10 schedule with no remote flexibility. As a union position, there...Remote workEpicHourly pay
$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- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
- ...necessary and efficient healthcare services, the full-time Utilization Review Specialist will evaluate patient records and treatment plans,... ...maintain compliance with regulatory standards while working remotely. Key responsibilities: Review and analyze medical records...Remote workFull time
$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 workWork at officeFlexible hours- ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Responsibilities Review...Remote workWork at officeFlexible hours
- ...Utilization Management Nurse Review patient medical records to determine the medical necessity and appropriateness... ...review findings accurately using Epic and Dragonfly utilization management... ...working independently in a remote environment and proficient with computer...Remote workEpicMonday to FridayShift workDay shift
- ...US 2 days ago Requisition ID: 9252 UR Specialist – Join Camber and Make an Impact At Camber... ...difference every day. Job Summary The Utilization Review department manages all aspects of a... ...of 2 days in office and 3 days remote after successfully completing their first...Remote workFull timeWork at officeMonday to Friday
$55k - $70k
...Utilization Review Specialist – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K About the Role As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare...Remote workFlexible hours$31.92 - $39.9 per hour
...Friday. Location: 100% remote. Job Overview This position reviews medical records to... ...admissions. Effectively utilizes ICD-10 CM and PCS codes... ...of deficiencies, within Epic, for missing documentation... ...equivalent. Certified Coding Specialist (CCS), Certified...Remote jobEpicWork experience placementWork at officeMonday to Friday- ...Assurance, and JHM Compliance to include review of documentation and revenue cycle performance... ...all coding and billing changes. Approved Remote Locations: Maryland, Virginia, Washington... ...of third party payer issues. Preferred EPIC experience. Salary Range: Minimum 22.33/...Remote workEpicWork experience placementWork at office
- Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote job
$75k
...Santa Barbara Cottage Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical necessity reviews and collaborating with clinical teams to make informed decisions. Candidates must hold an...Remote work- The Arizona Supreme Court is seeking a Program Specialist III for the Foster Care Review Board. This role focuses on facilitating citizen review boards... ...health and dental insurance, paid time off, and potential for remote work options. #J-18808-Ljbffr Arizona Supreme CourtRemote job
$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$22 - $36.32 per hour
...Coding Supervisor, ED, OP Surgery & Observation, the Coding Specialist II analyzes and... ...Specialist II will review medical record documentation... ...and claim edits. Utilizing a computerized... ...reviewing edits in Epic which includes an... ...needed. While this is a remote position, employees...Remote workEpicWork experience placement- ...This is a great opportunity for a local remote position. Schedule PRN (As needed... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing hospital admissions... ...after receiving the job offer. ~ EPIC experience is a plus! Overview...Remote workEpicReliefLocal areaWork from homeMonday to FridayFlexible hoursShift 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 jobContract workWork from home
- ...The Accounts Receivable Specialist follow up with... ...management and peers * Remote employee is responsible... ...private information, please review Insight Global's... ...In current position, utilizing Epic as billing system *... ...time zones) * Medicare/Medicaid experience * OBGYN billing...Remote workEpicMonday to Friday
- ...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
- ...Profee Surgical Coding Specialist III At Children's Wisconsin, we believe kids deserve the... ...Cardiothoracic and Vascular specialties. 100% Remote Full time: Monday-Friday (40 hrs per... .... Pro-Fee coding preferred. Epic experience preferred. Excellent communication...Remote jobEpicFull timeMonday to Friday
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