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Remote Authorization Utilization Review Bcba Jobs in Boca Raton, FL

NRG MGMT LLC

Collections Specialist

Lake Worth, FL · On-site +1

$16.50 - $22.25/hr

... utilization review, and insurance verification for substance abuse and mental health treatment ... Work Environment Office or remote work environment, depending on company policy. Fast-paced ...

Advanced Rx Management

Remote Specialist

Sunrise, FL · On-site +1

$17.25 - $23/hr

Review and track outstanding requests, maintaining accurate records and clear communication with ... Comfortable working in a remote-access environment and troubleshooting basic system navigation ...

Advanced Rx Management

Remote Specialist

Sunrise, FL · Remote

$17.25 - $23/hr

Review and track outstanding requests, maintaining accurate records and clear communication with ... Comfortable working in a remote-access environment and troubleshooting basic system navigation ...

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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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Certified Coder & Auditing (TEXAS BASED ONLY - MUST RESIDE)

Dane Street, LLC

West Palm Beach, FL • Remote

$23 - $31.50/hr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 days ago

Job description

MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred.

Requirements

We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred.

Responsibilities:

• Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS)

• Conduct utilization reviews to determine medical necessity and documentation compliance

• Review and prepare demand packages and audit response materials

• Analyze records for payer disputes and recoupments

• Prepare written audit findings and defensible reports

• Provide expert support for depositions and testimony as needed

• Review E/M services under 2021+ guidelines

• Interpret CMS, LCD/NCD, and payer-specific policies

• Identify risk areas and compliance vulnerabilities

Required Qualifications:

• Active CPC certification through the American Academy of Professional Coders (AAPC)

• CPMA preferred

• Minimum 5 years of professional coding experience

• At least 3 years of Texas-based coding experience required

• Strong knowledge of Texas Medicaid (TMHP) and Texas commercial payer policies

• Prior audit and utilization review experience required

• Experience supporting legal cases, depositions, or expert testimony strongly preferred

• Excellent written documentation and reporting skills

• Ability to work independently and meet deadlines

This position may be part-time depending on the candidate's qualifications. Texas residency is a requirement.

Benefits

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace. 

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.