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- ...Health Informatics Specialist III The Health Informatics... ...operational projects. Utilizing process improvement and... ...for developing, reviewing, approving and disseminating... ...experience, Remote patient monitoring experience... ...throughput optimization, Epic experience, Ambulatory...Remote workEpic
- ...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
- ...A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of experience...Remote work
$2,700 per week
...Lancesoft is seeking an experienced Utilization Review Registered Nurse for an exciting Travel Nursing... ...No. Pending License accepted: No Fully Remote Position Hospital Highlights Type of... ...no reddish orange permitted) Charting: EPIC Parking Cost: Facility Paid...Remote workEpicLocal areaImmediate startMonday to FridayShift workWeekend work- ...Revenue Cycle Specialist III Align yourself with an organization that... ...include but are not limited to, reviewing and submitting claims to... ...and system errors. *Approved Remote States: Arizona, California,... .... Experience with MS office, Epic, and CS-Link preferred. Working...Remote workEpicShift work
- RN Utilization Review RN Utilization Review MINIMUM REQUIRED QUALIFICATIONS: RN LENGTH OF ASSIGNMENT: 13 weeks SHIFT / HOURS PER WEEK: M-F 40 hours SYSTEMS: EPIC, InterQual START DATE: 7/20/26 AMN HealthcareRemote jobEpicShift work
- ...functions of a growing telehealth platform, the full-time Senior Utilization Review Specialist will manage the utilization review process, ensuring... ...with insurance companies and clinical staff in a remote work environment. Key responsibilities Oversee the entire...Remote workFull time
- ...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
$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- ...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
- Spectrum Billing Solutions is seeking an ABA Utilization Review (UR) Specialist to join their team. This fully remote or hybrid position involves reviewing clinical information and obtaining authorizations for ABA services. Candidates should have 3-5 years of relevant...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$75k
...WNS Global Services is seeking a fully remote Utilization Review Nurse to perform inpatient reviews and ensure compliance with medical necessity criteria. This role requires strong clinical collaboration with healthcare teams and the ability to communicate effectively...Remote workWork at office$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$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- ...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... ...a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Responsibilities Review...Remote workWork at officeFlexible hours
$60.15 - $67.75 per hour
...Single Path Coding (SPC) Specialist-Level 2 is an advanced... ...responsible for reviewing clinical documentation... ...Centers for Medicare and Medicaid Services (CMS) requirements... ...Ability to utilize the ICD-10-CM/PCS and... ...for medical records (Epic and 3M 360e Computer Assisted...Remote workEpicHourly payWork experience placementWork at officeLocal area- 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
- ...research center in Dallas is seeking a Coding Specialist III to perform complex coding tasks for the Revenue... ...requires expertise in ICD-10-CM and proficiency in EPIC systems, with at least 6 years of coding experience. Remote work is available for candidates residing in...Remote jobEpic
- ...Profee Surgical Coding Specialist III At Children's Wisconsin, we believe kids deserve the... ...CT Surgery. Position details: ~100% Remote ~ Full time: Monday-Friday (40 hrs per... ...knowledge. Pro-Fee coding preferred. Epic experience preferred. Excellent...Remote jobEpicFull timeMonday to Friday
$22.33 - $36.86 per hour
...Assurance, and JHM Compliance to include review of documentation and revenue cycle performance... ...coding and billing changes. Approved Remote Locations: Maryland, Virginia, Washington... ...third party payer issues. Preferred EPIC experience. Salary Range: $22.33/hour...Remote workEpicWork experience placementWork at officeLocal area$51 per hour
...Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote offsite) Type: Contract To Hire Compensation: $51/hr (W2) Work Model: 100% Remote Overview Utilizing key principles of utilization management, the Utilization Review Specialist (BCBA...Remote workContract workWork at officeWork from home$41.6k - $47k
...Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR... ...to stay organized and productive in a remote, independent work environment Proactive... ...healthcare programs (e.g., Medicare/Medicaid) PREFERRED QUALIFICATIONS ~1+...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work$2,080 per week
...Prime Staffing is seeking a travel nurse RN Remote Case Manager, Utilization Review for a travel nursing job in Santa Rosa, California. Job Description... ...as CC44s, ABNs, HINNs, MCSNs, etc. •Proficient with Epic, recent use required within the last 6-12 months About...Remote workEpicPermanent employmentTemporary workFor contractorsShift work- ...Certified Coding Specialist What we do here changes the world. UTHealth... ...is responsible for reviewing medical documentation provided... ...Houston Ob/Gyn Revenue Cycle - Remote (following in person training... ...Accountabilities: Resolves Epic Coding and Optum Claims Manager...Remote workEpicFull timeFor contractorsWork at office
- ...Overview The Utilization Management Specialist demonstrates excellent customer service... ...payer requirements, payer reviews, contacts, decisions and appeals... ...and the patient class in Epic (3‑point match). All... .... Manages and responds to Medicaid denials of inpatient cases...EpicContract workWork at officeLocal areaImmediate start
- ...Case Manager - Utilization Review Specialist - Remote Job Category: Utilization Management Requisition Number: CASEM035602 Posted: June 10, 2026 Full-Time Remote Quorum Corporate Office Brentwood, TN 37027, USA Description Case Manager - Utilization...Remote jobFull timeWork at office
- RCM Specialist III A Revenue Cycle Specialist III (RCS III) acts as a senior... ...Denial Management & Appeals: Reviewing and resolving complicated, denied... ...Expertise & Reporting: Utilizing EMR/practice management systems (e.g., Athena, Epic, Allscripts) to run, analyze,...Epic
$2,220 per week
...Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Hanover,... ...Travel Utilization Review Nurse (Remote) Location: 100% Remote Schedule: Monday... ...Utilization Review experience • Epic EMR experience • Proficiency with InterQual...Remote workEpicWeekly payContract workFor contractorsMonday to FridayShift work
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