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Assistant Remote Utilization Review Jobs in Illinois

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred * Physician Advisor Sub-Specialty Certification by the American Board of ...

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All JobsUtilization Review JobsAssistant Remote Utilization Review JobsAssistant Remote Utilization Review Jobs in Illinois

Assistant Remote Utilization Review information

What is the difference between Assistant Remote Utilization Review vs Utilization Review Nurse?

AspectAssistant Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certification in case management or utilization reviewRegistered Nurse (RN) license, often with additional certifications in case management or utilization review
Work EnvironmentRemote, administrative setting, telehealth or telecommutingRemote or hospital/clinic settings, primarily telehealth or administrative
Employer & IndustryHealth insurance companies, managed care organizations, healthcare providersHospitals, insurance companies, healthcare organizations

Both roles involve reviewing patient cases to determine appropriate care and resource utilization. The Assistant Remote Utilization Review typically supports the process with administrative tasks and basic review, while the Utilization Review Nurse performs more in-depth clinical assessments. Both require nursing credentials and often work remotely within healthcare or insurance industries.

What are the most commonly searched types of Remote Utilization Review jobs in Illinois? The most popular types of Remote Utilization Review jobs in Illinois are:
What are popular job titles related to Assistant Remote Utilization Review jobs in Illinois? For Assistant Remote Utilization Review jobs in Illinois, the most frequently searched job titles are:
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Assistant Remote Utilization Review jobs near you

ABA Utilization Review (UR) Specialist

Spectrum Billing Solutions

Skokie, IL • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 5 days ago

Job description

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client's revenue cycle is managed in the most 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 his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist external clients in understanding payer requirements for authorizations.
  • Participate in team meetings.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
  • Flexible work environment
  • Competitive Salary
  • A close-knit team of talented and skilled individuals.
  • Growth opportunities
  • Benefits - Medical, Dental, Vision
  • Flexible Paid Time Off
  • 401K with Company match
  • Supplemental Benefits
Qualifications:
  • 3-5 years of related ABA and/or Behavioral Health experience.
  • Bachelor's or master's degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services.
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