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Part Time Insurance Utilization Review Jobs in Pennsylvania

ANCHomeHealthService

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Office QA Nurse RN I $50 I Hour

Philadelphia, PA · On-site

$99K - $106K/yr

This is a part-time, in-office position with a flexible schedule of approximately 3 days per week ... Tracking compliance gaps, deficiencies, utilization review statistics, and other quality metrics ...

UHS

PSYCHIATRIST Part-Time

Centre Hall, PA · On-site

... in utilization reviews; remaining available for emergency consultations. - Improving staff ... insurance offering, a physician network and various related services located in 38 U.S. states ...

UHS

PSYCHIATRIST Part-Time

Centre Hall, PA · On-site

... in utilization reviews; remaining available for emergency consultations. - Improving staff ... insurance offering, a physician network and various related services located in 38 U.S. states ...

CHARTIERS CENTER

Therapist- Residential

Carnegie, PA · On-site

$50K - $68K/yr

Complete functional assessments, develop treatment plans and complete utilization reviews and ... Life Insurance * Retirement Plan- 6% Employer Contribution after 1 year * 8 Paid Holidays

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All JobsInsurance Utilization Review JobsPart Time Insurance Utilization Review JobsPart Time Insurance Utilization Review Jobs in Pennsylvania

Part Time Insurance Utilization Review information

What is the difference between Part Time Insurance Utilization Review vs Part Time Claims Reviewer?

AspectPart Time Insurance Utilization ReviewPart Time Claims Reviewer
CredentialsTypically requires insurance or healthcare-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, claims processing centers, or third-party administrators
Job FocusEvaluating medical necessity and appropriateness of servicesReviewing and processing insurance claims for accuracy and coverage

Part Time Insurance Utilization Review and Part Time Claims Reviewer roles both involve insurance industry work, but focus on different aspects. Utilization review centers on assessing medical necessity, while claims reviewers handle processing and verifying claims. Understanding these differences helps job seekers find the right fit based on their skills and interests.

What cities in Pennsylvania are hiring for Part Time Insurance Utilization Review jobs?

Cities in Pennsylvania with the most Part Time Insurance Utilization Review job openings:

Part Time Insurance Utilization Review jobs near you

Office QA Nurse RN I $50 I Hour

ANCHomeHealthService

Philadelphia, PA • On-site

$99K - $106K/yr

Part-time

Posted 11 days ago

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Key responsibilities

  • Review patient charts and clinical documentation for accuracy, completeness, and compliance with agency standards.

  • Conduct and support ongoing chart audits, documentation audits, and quality improvement reviews.

  • Track compliance gaps, deficiencies, utilization review statistics, and other quality metrics for leadership review.

Job description

Job description

ANC Home Health Services is seeking a detail-oriented Office QA Nurse to support our clinical quality, compliance, documentation, and patient care oversight processes. This is a part-time, in-office position with a flexible schedule of approximately 3 days per week.

The Office QA Nurse will work closely with the Administrator, Director of Nursing, and office leadership to ensure clinical documentation is accurate, patient records are up to date, compliance standards are met, and quality improvement efforts are consistently supported.


Position Details

Job Type: Part-Time
Schedule: 3 days per week, flexible days
Work Location: In-office
Pay: $38–$42 per hour
Reports To: Administrator / Director of Nursing
Exposure Risk: Limited risk of exposure to bloodborne pathogens


Key Responsibilities

The Office QA Nurse will assist with quality assurance, chart audits, compliance tracking, and clinical documentation review. Responsibilities include:

  • Reviewing patient charts and clinical documentation for accuracy, completeness, and compliance with agency standards.
  • Conducting and supporting ongoing chart audits, documentation audits, and quality improvement reviews.
  • Working from an assigned client list to ensure all clinical documentation is current and properly maintained.
  • Tracking compliance gaps, deficiencies, utilization review statistics, and other quality metrics for leadership review.
  • Participating in case conferences and supporting accurate documentation of care planning and follow-up.
  • Reviewing complaints, incidents, errors, and grievances and assisting with timely documentation and resolution.
  • Supporting risk management efforts related to patient safety, staff safety, infection control, and quality care standards.
  • Monitoring patient satisfaction through documentation review, feedback, and follow-up as needed.
  • Supporting staff education related to documentation, compliance, and quality care expectations.

Collaborating with administrative, nursing, and supervisory staff to ensure quality patient care and regulatory compliance.

  • Maintaining confidentiality of patient and personnel information at all times.


Qualifications

Current Registered Nurse (RN)

Prior home health, home care, skilled nursing, or healthcare quality assurance experience strongly preferred.

  • Experience with chart audits, clinical documentation review, compliance monitoring, or quality improvement preferred.
  • Strong attention to detail and ability to identify documentation issues or compliance gaps.
  • Excellent communication, organization, and follow-through skills.
  • Ability to work independently while collaborating with office leadership and clinical staff.
  • Comfortable using a computer, electronic records, office equipment, and basic healthcare documentation systems.
  • Must be able to successfully pass a criminal background check.


Ideal Candidate

The ideal candidate is a nurse who understands the importance of accurate documentation, compliance, and quality patient care. This role is best suited for someone who is organized, dependable, comfortable working in an office setting, and able to help the agency stay proactive with quality assurance and regulatory expectations.


About ANC Home Health Services

ANC Home Health Services provides skilled and non-skilled home health services with a focus on patient-centered care, compliance, and quality outcomes. We are looking for a nurse who can help strengthen our office-based QA and clinical oversight processes as our agency continues to grow.


How to Apply

Please submit your resume for consideration. Qualified applicants may be contacted to schedule an interview.

Company Description

ANC Home Health Services is a Homecare-based agency that services throughout Philadelphia and related areas. We help connect those in need with those willing to serve to provide quality based care.

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About ANCHomeHealthService

Sourced by ZipRecruiter

Our goals and services are based on two fundamental philosophical principles: the belief in the innate worth of the aged and the disabled individual and the belief that each individual, regardless of race, color, creed, sex, national origin and handicap(s) is entitled to maximize his potential as a Human being and as a member of Society. It is the contention of this Agency that the aging process is a normal state in the development of any individual and that chronic disease and the disability are, to some degree, a part of that process. This Agency is dedicated to rehabilitating aged and disabled individuals within the confines of their residence, in order that they may maximize their contributions and fulfill their goals as a family member and member of society with a minimum of conflict. In accomplishing this end, it is felt that the self-respect of the individual can and will be enhanced. Our Agency is also a vital member of its Community. As an employer, the Agency practices non discrimination and strives to provide opportunities for personal and professional growth. As an integral part of the business community, the Agency makes every effort to serve the people with attention to current area practices and specific needs.

Industry

Health care and social assistance

Company size

51 - 200 Employees

Headquarters location

Philadelphia, PA, US

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