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Internship Remote Utilization Review Jobs in Missouri

Remote - Inpatient Coder II

Saint Joseph, MO ยท On-site +1

$21 - $25.25/hr

This assignment is based on evaluation of the documentation in the medical record and utilization ... Reviews and appeals coding denials. * Educates/Communicates with providers, querying providers to ...

This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...

New

This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...

New

This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...

New

This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...

New

This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...

New

$94K - $124K/yr

Write automated tests, participate in code reviews, and contribute to release quality through CI/CD ... Fully remote, globally distributed work environment. * Flexible working hours and strong work-life ...

New

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Internship Remote Utilization Review information

What are the main challenges interns face when working remotely in Utilization Review, and how can they overcome them?

Remote Utilization Review interns often encounter challenges in balancing independent work with effective communication, especially when collaborating with clinical teams or supervisors. Staying organized and proactively reaching out for guidance can help bridge gaps caused by remote settings. Utilizing available digital tools, attending virtual meetings, and participating in team chats fosters connection and learning. Setting a structured daily schedule and seeking regular feedback ensures that interns stay aligned with team goals and develop their review skills efficiently.

What is a Remote Utilization Review Internship?

A Remote Utilization Review Internship is a temporary position, often for students or recent graduates, that allows individuals to work remotely while learning about utilization review processes in healthcare. Interns assist in evaluating medical records, ensuring that healthcare services provided to patients are medically necessary and meet established guidelines. They work under the supervision of licensed professionals, gaining experience in medical documentation, insurance policies, and healthcare regulations. This role is ideal for those interested in healthcare administration, nursing, or case management.

What is the difference between Internship Remote Utilization Review vs Utilization Review Specialist?

AspectInternship Remote Utilization ReviewUtilization Review Specialist
CredentialsTypically pursuing or holding relevant certifications (e.g., CCM, RN)Requires active certification and experience in utilization review
Work EnvironmentRemote, internship setting, often part-time or supervisedFull-time, remote or onsite, with more independent responsibilities
Industry UsageEntry-level, training phase within healthcare and insurance sectorsProfessional role with established responsibilities in healthcare management

In summary, an Internship Remote Utilization Review is a training position for individuals gaining experience in utilization review, often with supervision and limited responsibilities. A Utilization Review Specialist is a fully qualified professional responsible for evaluating healthcare services, requiring certifications and more independence in their role.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review Intern, and why are they important?

To thrive as a Remote Utilization Review Intern, you need a foundational understanding of healthcare processes, medical terminology, and insurance guidelines, often supported by a relevant degree or coursework in nursing, health administration, or a related field. Familiarity with electronic medical record (EMR) systems, utilization review software, and HIPAA compliance is typically required. Strong attention to detail, analytical thinking, and effective written communication are standout soft skills in this role. These abilities are crucial for accurately reviewing patient cases, ensuring regulatory compliance, and supporting efficient healthcare delivery from a remote setting.
What are the most commonly searched types of Remote Utilization Review jobs in Missouri? The most popular types of Remote Utilization Review jobs in Missouri are:
What cities in Missouri are hiring for Internship Remote Utilization Review jobs? Cities in Missouri with the most Internship Remote Utilization Review job openings:

MDS Solutions - Clinical Reimbursement Specialist

MDS Solutions

Kansas City, MO โ€ข On-site, Remote

Other

Medical, Dental, Life, Retirement, PTO

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Overview

MDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Clinical Reimbursement Specialist.

Clinical Reimbursement Specialist (CRS)The Clinical Reimbursement Specialist (CRS) plays a critical role in supporting clients through specialized project work, including conducting RAI assessments, developing comprehensive care plans, and delivering targeted education and training to MDS Coordinators on the Resident Assessment Instrument (RAI) process. This work is performed in strict alignment with applicable laws, regulations, and company standards. The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized reimbursement. Additionally, the CRS provides support with interim long-term and short-term contract coordination, ensuring the smooth completion of these efforts

About Us:

At Key Rehab, we're shaking up rehab services with a fresh, standout approach. We offer a wide range of services, stick to top-notch systems, and work in strategic locations to get the best results for our patients and support our clients' goals. We're all about clear communication, using our deep experience to deliver therapy that's both effective and affordable. Our reputation is built on great patient care, happy clients and staff, and solid management. We are proud to exceed expectations for patients, families, healthcare providers, and businesses.

We prioritize both exceptional patient care and the well-being of our employees. We are committed to delivering compassionate, results-driven therapy while offering the flexibility and comprehensive benefits needed to thrive in today's healthcare environment. Our team is large enough to offer competitive pay and benefits but small enough to ensure personalized attention and support for your career aspirations.

Whether you're looking for a role that accommodates family commitments, travel plans, home projects, or future savings, we provide tailored solutions to fit your lifestyle. Join us and experience a workplace that values your individual needs and career goals. Come experience a rewarding career where you're valued and supported every step of the way.

We offer a creative, engaging, and flexible work environment, alongside a comprehensive benefits package designed to support your success and well-being:

  • Competitive salaries with bonus opportunities
  • Ample opportunities for promotion, transfer, and advancement
  • Work that is meaningful, fulfilling, and provides high job satisfaction
  • Reasonable working hours promoting work-life balance
  • Continuing education (CE) opportunities for ongoing professional development
  • Generous paid time off
  • Comprehensive health, dental, and life insurance packages
  • 401K with discretionary matching
  • Mileage and licensure reimbursements
  • Flexible Spending Account (FSA) and Health Savings Account (HSA) options
Responsibilities
  • Serve as a trusted advisor to healthcare agencies and facilities, offering expert guidance and insights to optimize their operations.
  • Assist clients in assessing, planning, developing, and implementing systems and processes related to reimbursement, tailored to the specific needs and contracts established with each client.
  • Provide consulting services and technical expertise, including interim MDS management, ensuring providers receive the support they need to achieve optimal outcomes.
  • Stay up-to-date on professional standards of clinical care, federal and state regulations, QM measures, and the RAI process to ensure the delivery of accurate, compliant, and effective solutions.
  • Deliver high-quality, professional services that encompass reimbursement optimization, staff education, in-depth research, system analysis, creative problem-solving, and the presentation of actionable recommendations to clients.
  • Identify and address training needs, developing and conducting training sessions or in-service programs as requested by clients to enhance staff competency and performance.
  • Operate within the defined scope of work, maintaining strict adherence to client agreements and expectations.
  • Uphold client confidentiality and ensure full compliance with HIPAA regulations, safeguarding sensitive information throughout the engagement.
Qualifications

Minimum Qualifications:

  • Bachelor's degree in nursing from an accredited college or university, with at least five (5) years of clinical experience, including 3+ years specializing in the RAI process.
  • Current and unrestricted RN ,along with active RAC-CT certification, ensuring adherence to industry standards and best practices.
  • Possesses exceptional critical thinking skills, with the proven ability to make informed decisions, demonstrate sound clinical judgment, and apply expert knowledge in quality improvement concepts and processes.
  • Demonstrates strong leadership abilities and excels in interpersonal communication, fostering collaboration, and guiding teams to achieve optimal clinical outcomes.

Key Rehab is an equal opportunity employer/service provider.

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Employment Type: OTHER