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Remote Authorization Utilization Review Bcba Jobs in Rochester, MN

The individual should have a firm understanding of HIPAA-compliance and when an authorization is ... This is a hybrid position that is primarily remote. Candidates must reside within 100 miles of a ...

The work model for the role is Remote based out of Florida, USA. This role is contributing to the ... Must be legally authorized to work in the United States without company sponsorship now and in the ...

Specialist-HIMS

Rochester, MN · On-site +1

$16.50 - $21.75/hr

... authorizations, requesting historical medical records, and preparing correspondence in response to ... This is a hybrid position that is primarily remote. Candidates must reside within 100 miles of a ...

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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Senior Specialist HIMS

Mayo Clinic

Rochester, MN • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement

Re-posted 19 days ago


Mayo Clinic rating

7.8

Company rating: 7.8 out of 10

Based on 706 frontline employees who took The Breakroom Quiz

136th of 898 rated healthcare providers


Job description

The HIMS Senior Specialist should have a broad knowledge of an electronic health record (EHR), specifically Epic.  The individual should have a firm understanding of HIPAA-compliance and when an authorization is needed before disclosing protecting health information.  Responsible for the comprehensive processing of all types of requests for medical information to include customer service for walk-ins, opening and processing incoming mail, verifying authorizations, requesting historical medical records, and preparing correspondence in response to a request for medical information. In addition, this individual is responsible for the completion of quality assurance monitoring of the work performance of HIMS Specialists and reporting their findings to the HIMS Supervisor.  Acts as a resource for the HIMS Specialist and completes ad-hoc projects. The HIMS Sr. Specialist will also assist with training new or contract staff and students in a qualitative and effective manner.  Prefer that the candidate has prior ROI experience and customer service experience. 

Supports patient safety and quality care by being knowledge experts of the health care record achieved through quality documentation, integrity of the EHR, timely and accessible health information, regulatory compliance. Coordinates and maintains the flow and content of patient health information in both paper and electronic formats. Analyzes patient information to ensure compliance with standards established by Federal/State & Joint Commission & CMS regulations. Coordinates with clinicians to ensure documentation contains all required elements and is completed in a timely manner. Adheres to, and helps develop, institutional policies regarding health care documentation. Utilizes independent analytical and critical thinking skills. Works independently and collaboratively across the enterprise with minimal supervision. Adheres to guidelines with regard to accessing minimum necessary information to complete job function. Adheres to state and federal rules regarding privacy and confidentiality of protected health information. Leverages technology to serve the patients and practice. Assists in developing and training HIMS operational teams. Professionally communicates through all electronic, written, and verbal methods. Ensures great customer service while assisting patients, care providers, allied health staff, attorneys, insurance companies, government audits, and others in a courteous, professional and confidential manner.

This is a hybrid position that is primarily remote. Candidates must reside within 100 miles of a Mayo Clinic campus to meet occasional on-site requirements based on business needs. Mayo Clinic campuses are located in Arizona, Florida, Minnesota, and Wisconsin

**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.

During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.

Why Mayo Clinic

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.

Benefits Highlights
  • Medical: Multiple plan options.
  • Dental: Delta Dental or reimbursement account for flexible coverage.
  • Vision: Affordable plan with national network.
  • Pre-Tax Savings: HSA and FSAs for eligible expenses.
  • Retirement: Competitive retirement package to secure your future.
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. 

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law".  Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

Associate's degree in Health Information Technology. Health Information Technician (HIT) program students actively completing the last semester of the program will be considered; successful completion of HIT program required within 6 months of employment for continued employment.Demonstrated understanding of Joint Commission standards, State Regulations, and CMS requirements. Must possess knowledge of medical records format and content with the ability to perform work in a fast paced, constant change, production environment with a focus on quality. Must possess excellent customer service skills and be able to clearly, concisely and professionally communicate verbally and in written forms. Demonstrated ability to maneuver in multi technology environment and demonstrates proficiency in Microsoft Office (Excel, Word, Outlook) applications. Keyboarding skills required with intermediate typing/keyboard/computer skills. Versed in government regulatory and legal healthcare requirements to protect the patient and organization. Demonstrated medical terminology knowledge and basic project management skills. RHIT or RHIA certification required.


What Mayo Clinic employees say

Pay

Benefits

Hours and flexibility

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About Mayo Clinic

Sourced by ZipRecruiter

Mayo Clinic is the largest integrated, not-for-profit medical group practice in the world. We're building the future, one where the best possible care is available to everyone — and more people can heal at home. Our relentless research turns into earlier diagnoses and new cures. That's how we inspire hope in those who need it most. At Mayo Clinic, experts work together to solve the most challenging unmet needs of patients. Our history of innovation dates back almost 150 years, when brothers Will and Charlie Mayo pioneered an integrated, team-based approach to medicine. Today, that trailblazing spirit drives innovations like Mayo Clinic Platform — which powers new technologies to change how care is delivered to all.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Rochester, MN, US

Year founded

1919