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Remote Bcba Utilization Review Jobs in Tennessee

Revecore

Nurse Consultant

Franklin, TN · Remote

Remote-USA The Role: Denial Prevention Nurse Consultant Primarily responsible for thorough review ... Minimum 5 years of related experience and/or training in utilization review or patient accounting

New

Charlie Health

Patient Finance Specialist

Nashville, TN · Remote

$17.50 - $23.25/hr

... Billing, Utilization Review, Outreach and Clinical * Support client-related requests from the ... LI-Remote Based on the nature of this role, you will need to complete several state background ...

VIVA USA INC

Nurse Case Manager

Nashville, TN · On-site +1

... utilization management to members. Performs prospective, concurrent, and retrospective reviews for ... Remote in any state except, NY, CA, HI and AK VIVA is an equal opportunity employer. All qualified ...

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Remote Bcba Utilization Review information

What is a Remote BCBA Utilization Review?

Remote BCBA Utilization Review jobs involve Board Certified Behavior Analysts (BCBAs) who review and assess the medical necessity and effectiveness of Applied Behavior Analysis (ABA) therapy services, usually for insurance companies or healthcare organizations. These professionals work remotely to evaluate clinical documentation, ensure compliance with treatment guidelines, and approve or deny service requests based on established criteria. The role helps ensure that clients receive appropriate care while also managing costs for payers. Strong analytical and communication skills are essential, as is up-to-date BCBA certification.

What are the key skills and qualifications needed to thrive as a Remote BCBA Utilization Review?

To excel as a Remote BCBA Utilization Review specialist, you need Board Certified Behavior Analyst (BCBA) certification, in-depth knowledge of applied behavior analysis (ABA), and experience with clinical documentation standards. Familiarity with electronic health record (EHR) systems, utilization review platforms, and insurance authorization processes is typically required. Strong analytical thinking, attention to detail, and effective written communication distinguish top performers in this role. These competencies ensure accurate service reviews, compliance with payer requirements, and support for quality client care in a remote environment.

What are some common challenges faced by a Remote BCBA Utilization Review professional, and how can they be managed?

Remote BCBA Utilization Review professionals often encounter challenges such as balancing thorough case evaluations with productivity targets and adapting to varying documentation standards from different providers. Effective time management and strong communication skills are key to addressing these challenges. Additionally, staying current with payer guidelines and collaborating closely with clinical teams can help ensure accurate and efficient reviews, ultimately supporting high-quality care for clients.

What is the difference between Remote Bcba Utilization Review vs Remote Bcba Case Manager?

AspectRemote Bcba Utilization ReviewRemote Bcba Case Manager
CertificationsBCBA, possibly additional utilization review credentialsBCBA, case management certifications often preferred
Work EnvironmentReviewing medical and treatment plans remotely, focusing on insurance and authorizationCoordinating care, managing cases, and supporting clients remotely
Employer & IndustryHealthcare, insurance companies, behavioral health providersBehavioral health agencies, healthcare organizations

Both roles require BCBA certification and involve remote work, but the Utilization Review focuses on evaluating treatment plans for insurance approval, while the Case Manager manages ongoing client care and services. Understanding these differences helps professionals choose the right career path in behavioral health.

What are the most commonly searched types of Bcba Utilization Review jobs in Tennessee?

The most popular types of Bcba Utilization Review jobs in Tennessee are:

What are popular job titles related to Remote Bcba Utilization Review jobs in Tennessee?

For Remote Bcba Utilization Review jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Remote Bcba Utilization Review jobs in Tennessee look for?

The top searched job categories for Remote Bcba Utilization Review jobs in Tennessee are:

What cities in Tennessee are hiring for Remote Bcba Utilization Review jobs?

Cities in Tennessee with the most Remote Bcba Utilization Review job openings:

Remote Bcba Utilization Review jobs near you
Infographic showing various Remote Bcba Utilization Review job openings in Tennessee as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% Remote job distribution.

Admissions Services Specialist Acute

Acadia Healthcare

Franklin, TN • Remote

$18 - $24.75/hr

Full-time

Re-posted 16 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

698th of 889 rated healthcare providers

Job description

Admissions Services Specialist

Location: Remote

Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast.

Our Mission

Acadia Healthcare’s purpose is to Lead Care With Light and our mission is to be a world-class organization that sets the standard for excellence in the treatment of mental health and addiction concerns. We strive to maintain our standing as a thought leader in the behavioral healthcare industry, providing treatment that is synonymous with compassion and innovation.

Highlights of this role include:

  • Ability to verify benefits information for assigned facility
  • 1 weekend day shift Friday, Saturday, Sunday
  • Experience monitoring and processing patient referrals (may include fax referrals)
  • Respond to inquiries about facilities within policy timeframes
  • Support Acadia Healthcare admissions departments throughout the country

As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need.


This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity.


Essential Functions

  • Manage Referral Management Portals
  • Monitor all faxed referrals
  • Monitor all webforms and call center handoffs/rollover referrals
  • Utilize facility admissions/exclusionary criteria to process incoming types of referrals
  • Respond to inquiries about the facility within facility policy timeframes.
  • Document calls inside of Salesforce and follow-up as needed
  • Complete Prior Authorization
  • Pre-Admit the patients in billing system
  • Coordinate with local admissions department regarding bed availability
  • Facilitate intake, admissions, and utilization review process for incoming patients.
  • Perform insurance benefit verifications, disseminating the information to appropriate internal staff
  • Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals
  • Coordinate admission and transfer between levels of care within the facility
  • Communicate projected admissions to designated internal representative in a timely manner
  • Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission
  • Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality
  • Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team

Education/Experience/Skill Requirements

  • Bachelor’s or Master’s degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN
  • Knowledge of admission/referral processes, techniques, and tools
  • Familiarity with behavioral health issues and services
  • Solid understanding of financial principles and insurance reimbursement practices
  • Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application.

 

Licenses/Designations/Certifications

  • Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates.

 

Supervisory Requirements

  • This position is an Individual Contributor

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

AHCORP

#LI-TB1

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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