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Remote Authorization Utilization Review Bcba Jobs

Nexus Health Systems

Remote UTILIZATION REVIEW NURSE - RN

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Remote Utilization Review Registered Nurse (UR RN) Location: Remote (Texas RN License or Compact ... Manage insurance authorizations, denials, appeals, and level-of-care determinations. * Monitor ...

New

Netsmart

Utilization Review Nurse

... authorization * Review, analyze, and identify utilization patterns and trends, problems, or ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...

McBee Associates

Utilization Review Nurse

... authorization * Review, analyze, and identify utilization patterns and trends, problems, or ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...

System One

Utilization Management Coordinator

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...

System One

Utilization Management Coordinator

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...

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Remote Authorization Utilization Review Bcba information

Can you work remotely as a remote authorization utilization review BCBA?

A remote authorization utilization review BCBA can typically perform their duties remotely, as the role involves reviewing clinical documentation and authorization requests, which can be done online. Successful remote work often requires strong communication skills, familiarity with electronic health records, and relevant certifications such as the BCBA credential. However, specific employer policies and state licensing requirements may influence the ability to work remotely in this role.

Is utilization review work from home?

Remote Authorization Utilization Review BCBA positions typically allow for work from home, especially when conducting chart reviews, documentation, and telehealth assessments. However, some roles may require occasional in-office visits or supervision, depending on employer policies and state regulations.

What are the key skills and qualifications needed to thrive as a remote authorization utilization review BCBA?

To thrive as a Remote Authorization Utilization Review BCBA, you need board certification as a Behavior Analyst (BCBA), deep knowledge of ABA therapy, and experience with clinical documentation and insurance authorization processes. Familiarity with electronic health record (EHR) systems, payer portals, and healthcare compliance tools is typically required. Strong analytical skills, attention to detail, and effective written communication are essential soft skills for success in this remote role. These competencies ensure accurate authorization reviews, compliance with regulations, and efficient support for patients and providers across virtual settings.

How does a remote authorization utilization review BCBA typically collaborate with healthcare providers and insurers during the review process?

A Remote Authorization Utilization Review BCBA frequently communicates with both healthcare providers and insurance representatives to assess and justify the necessity of ABA services for clients. This involves reviewing clinical documentation, clarifying treatment plans, and sometimes participating in peer-to-peer discussions to support authorization requests. Strong written and verbal communication skills are essential, as much of the collaboration is done via phone, email, or secure portals. Building positive relationships and ensuring clear, evidence-based recommendations can help streamline approvals and improve outcomes for clients.

What is a remote authorization utilization review BCBA?

A Remote Authorization Utilization Review BCBA is a Board Certified Behavior Analyst who works remotely to review and approve treatment plans for clients, typically in the context of Applied Behavior Analysis (ABA) therapy. Their main responsibility is to assess clinical documentation and ensure that the recommended services meet medical necessity criteria and payer guidelines. This role often involves collaborating with clinicians, insurance companies, and families to facilitate the authorization process for behavioral health services. Working remotely allows BCBAs in this position to provide their expertise from any location, using digital tools to conduct reviews and communicate with stakeholders.
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Remote Authorization Utilization Review Bcba jobs near you
Infographic showing various Remote Authorization Utilization Review Bcba job openings in the United States as of August 2026, with employment types broken down into 69% Full Time, 23% Part Time, and 8% Contract. Highlights an 100% Remote job distribution.

Utilization Review Specialist (Remote) - Behavioral Health

Adolescent Wellness Academy

Davie, FL • Remote

Full-time

Posted 9 days ago

Job description

Remote Authorization Specialist

Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour

About the Role
This role manages insurance authorization for clients across our PHP and IOP programs - completing pre-certifications, concurrent reviews, verifying benefits, obtaining Single Case Agreements, and managing appeals so that client access to treatment is never disrupted by a payer issue.

Backgrounds that translate well: Utilization Review Insurance Authorization/Precertification Behavioral Health Case Management

What You'll Do

  • Verify benefits and eligibility prior to admission and throughout treatment
  • Complete pre-certifications, concurrent reviews, and re-certifications for PHP/IOP levels of care
  • Obtain Single Case Agreements with out-of-network payers
  • Build the medical necessity case using ASAM, LOCUS, and CALOCUS criteria
  • Prepare and submit appeals on denied authorizations
  • Maintain accurate, audit-ready authorization, denial, and SCA records

What We're Looking For

Required

  • 2+ years of experience as a UR/authorization specialist at the PHP and IOP levels of care for a mental health or substance use facility
  • Working knowledge of ASAM, LOCUS, and CALOCUS criteria and medical necessity standards
  • Strong organizational skills with the ability to manage multiple authorizations and deadlines concurrently
  • Strong familiarity with EMR platforms and authorization software
  • Strong written and verbal communication skills, with the ability to advocate effectively with payers
  • Eligible for DCF and AHCA Level 2 Background Check

Preferred

  • CPT/ICD-10 and DSM-5 familiarity
  • Multi-payer SCA experience
  • Bilingual (English/Spanish)
  • Kipu or similar EMR experience

AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. We exist to serve clients and families at their most critical moments - and this role sits at the front door of that mission.


Learn More: Adolescent Wellness Academy Principles Recovery Center

Employment Type: FULL_TIME

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