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- ...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- ...Utilization Review Specialist The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients... ...insurance companies. Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines....Remote work
- ...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
- ...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
- ...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
$55k - $70k
...support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000 - $70,000 a... ...position and must have prior UR & clinical experience. Remote hires and applicants without prior experience will not be...Remote workFull timeWork at office$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- ...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...Remote work
- ...Description Overview Director of Utilization Review (RN) – Midland/Odessa, Texas... ...reviews with commercial, Medicaid, Medicare Advantage, and... ...are performed on campus. Remote, virtual, or hybrid work arrangements... ...with EMRs such as Epic, Cerner, MediTech, or Sigmund...Remote workEpicWork at officeRelocation package
$50k
...the 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- ...providing low-cost RCM solutions to maximize insurance reimbursements quickly and efficiently. They are seeking a Utilization Review Specialist to join their remote team. This role is responsible for performing utilization reviews, managing concurrent reviews, handling...Remote work
$26.51 - $43.76 per hour
...Assurance, and JHM Compliance to include review of documentation and revenue cycle performance... ...coding and billing changes. Approved Remote Locations: Maryland, Virginia,... ...third party payer issues. Preferred EPIC experience. Salary Range: $26.5...Remote workEpicWork experience placementWork at officeLocal area- ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers... ...in a cohesive and rewarding environment. This is a fully remote or office/home hybrid position. Your Responsibilities:...Remote workWork at officeFlexible hours
- ...Utilization Review Specialist | Remote | Full-Time Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 5075 patients, conducting admission and...Remote workFull timeTemporary work
- ...Utilization Review Specialist The primary purpose of the Utilization Review Specialist is to create and manage the flow of revenue for each client... ...Satisfactory CORI and background check. Satisfactory drug screen Part Time Remote Role Charles River RecoveryRemote workPart timeWork at officeFlexible hours
- 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
- ...Location Position is Remote-Must live in one... ...of the Coding Specialist II is to code and... ...responsible for charge review on clinic and... ...understanding the utilization of modifiers and other... .... •Knowledge of Epic EHR and 3M 360... ...Centers for Medicare & Medicaid Services (CMS)...Remote workEpicContract workLive inLocal area
$16.74 - $26.92 per hour
...Description Job Description The Utilization Review (UR) Intake Specialist provides staff support services including... ...time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours$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- ...CARC/RARC denial codes, Epic denial work queues, and... ...across Medicare, Medicaid, and commercial payers.... ...Responsibilities Denial Review & Resolution – PB & HB... ...actions and resolutions. Utilize payer portals (Availity... ...and orderly remote work area. Meet specified...Remote workEpicWork experience placementLocal area
- ...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...Remote workEpicFull timeFor contractorsWork at office
$29.62 - $45.31 per hour
...Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department... ...requests, customer service inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote work for candidates...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...This is a great opportunity for a local remote position. Schedule PRN (As needed)... ...for hospitalized patients. 2 years of utilization review (UR) experience reviewing hospital admissions... ...started after receiving the job offer. EPIC experience is a plus! Overview BJC...Remote workEpicReliefLocal areaMonday to FridayFlexible hoursShift work
$23 - $25 per hour
...company reimagining how Medicaid and Medicare... ...Community Engagement Specialist who is willing to... ...allows for remote work; however, you... ...technology tools utilized for the position... ...States Virtual Ops requires a quiet,... ...Our team regularly reviews applications and will...Remote workHourly payFull timeLocal areaWork from homeFlexible hoursWeekend work- ...Monday-Friday 8am-4:30pm Remote Summary: The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding... ..., Centers for Medicare & Medicaid Services, American Association... ...professional journals) # Reviews EPIC work queues daily for...Remote workEpicFull timeMonday to Friday
- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The... ...or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills...Remote work
- ...SSM Health in the United States seeks a registered nurse for utilization management to evaluate medical necessity of hospital admissions and procedures. You will ensure payors receive complete clinical information to support services provided and obtain hospital authorization...Remote workDay shift
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