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Remote Authorization Utilization Review Bcba Jobs in Florida

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Working closely with operational leaders across Claims, Prior Authorization, Utilization Management ... Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY. Hybrid ...

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Remote Authorization Utilization Review Bcba information

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.

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.

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Remote Authorization Utilization Review Bcba jobs near you

Utilization Review Coordinator

NRG MGMT LLC

Lake Worth, FL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 15 days ago

Job description

Remedial Pro is a specialized medical billing company serving substance abuse treatment and behavioral health providers. Through services including benefits verification, billing and claims submission, and utilization review, we help treatment centers optimize revenue cycle management while focusing on delivering exceptional patient care. Our team is committed to accuracy, professionalism, efficiency, and outstanding client service

JOB DESCRIPTION

The primary goal is to monitor adherence to the facility’s utilization review plan to ensure the effective and efficient use of facility services and monitor the appropriateness of facility  admissions and extended facility stays.

Job Classification: Non Exempt Hourly        Reports To: Senior RCM Director

Supervisory Responsibilities:   None.

JOB DUTIES:

  • Completes Initial, concurrent, peer reviews, and expedited appeals in a timely manner to ensure continuous coverage.
  • responsible for all aspects of the authorization of treatment via insurance and managed care companies.
  • Utilize clinical information and knowledge of Medical Necessity criteria to effectively communicate plans of care to insurance case managers, facility staff, and healthcare partners.
  • Collaborate with facilities in order to obtain necessary clinical documentation for reviews and ensure appropriate lengths of stay and effective utilization of resources.
  • Represents the company in a positive manner per the Professional Standards of Conduct
  • Protects the confidentiality of patients and the privacy of staff
  • provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner.
  • Uses a computer to type correspondence, reports and other items as requested,
  • Experience in the Mental Health/Addiction space, May be a fully licensed SUDC, CAC,LADC, LCSW, CMHC or RN
  • Additional duties as assigned.

MINIMUM QUALIFICATIONS

  • Bachelor’s or Master’s degree in Behavioral/Mental Health Field (or related experience) preferred
  • A minimum of 3-5 years experience doing utilization review is required preferred
  • Expertise in psychiatric and addiction disorders
  • Experience interacting effectively with co-workers as well as clients.
  • Experience maintaining confidentiality in accordance with HIPAA and company policy requirements.

Required Skills/Abilities:

  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Proficient with Microsoft Office Suite or related software.
PHYSICAL REQUIREMENTS
  • Prolonged periods sitting at a desk and working on a computer.

Remote Position

Benefits:

• Competitive salary

• Health, dental, and vision insurance

• 401(k) with company match

• Paid time off and holidays

• Continuing education and professional development opportunities

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