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Remote Behavioral Health Utilization Review Jobs in Tennessee

Vertek Staffing

CDI Specialist

Franklin, TN · Remote

$33.50 - $45/hr

CDI Specialist - Remote Acute Care Hospital Experience Required Required Education * High School ... The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review ...

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How much do remote behavioral health utilization review jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for remote behavioral health utilization review in Tennessee is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 per hour, depending on experience, location, and employer.

What is a remote behavioral health utilization review?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are the most commonly searched types of Behavioral Health Utilization Review jobs in Tennessee? The most popular types of Behavioral Health Utilization Review jobs in Tennessee are:
What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Tennessee? For Remote Behavioral Health Utilization Review jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Behavioral Health Utilization Review jobs in Tennessee look for? The top searched job categories for Remote Behavioral Health Utilization Review jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Behavioral Health Utilization Review jobs? Cities in Tennessee with the most Remote Behavioral Health Utilization Review job openings:
Remote Behavioral Health Utilization Review jobs near you
Infographic showing various Remote Behavioral Health Utilization Review job openings in Tennessee as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $79,822 per year, or $38.4 per hour.

CDI Specialist

Vertek Staffing

Franklin, TN • Remote

$33.50 - $45/hr

Contractor

Re-posted 14 days ago

Job description

CDI Specialist - Remote

Acute Care Hospital Experience Required

Required Education
  • High School Diploma required with submission
Required Certifications & Licensure

Online certification verification required with submission.

Required:

  • Active, unrestricted Registered Nurse (RN) license

Preferred Certifications:

  • Certified Clinical Documentation Specialist (CCDS) - ACDIS
  • Certified Documentation Improvement Practitioner (CDIP) - AHIMA
  • Certified Coding Specialist (CCS) - AHIMA
  • Registered Health Information Administrator (RHIA) - AHIMA
  • Registered Health Information Technician (RHIT) - AHIMA
Schedule
  • Monday - Friday
  • Occasional weekend coverage may be required based on client needs
Position Summary

The CDI Specialist is responsible for improving the overall quality and completeness of clinical documentation within the medical record. Through concurrent review of patient records, the CDI Specialist collaborates with physicians, nursing staff, coding professionals, case management, and other healthcare team members to ensure documentation accurately reflects severity of illness, risk of mortality, quality measures, and resource utilization.

The CDI Specialist identifies opportunities for documentation clarification through compliant physician queries and helps ensure documentation supports accurate coding, reimbursement, quality reporting, and denial prevention.

This role requires strong clinical knowledge, critical thinking skills, and a thorough understanding of ICD-10-CM/PCS coding guidelines, MS-DRG assignment, APR-DRG methodologies, and regulatory requirements.

The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review, Physician Advisors, and providers to support accurate and complete clinical documentation.

Key Responsibilities
  • Conduct concurrent reviews of inpatient medical records to identify documentation improvement opportunities.
  • Initiate compliant physician queries to clarify diagnoses, procedures, severity of illness, risk of mortality, and present-on-admission indicators.
  • Collaborate with Coding, HIM, Case Management, Utilization Review, and clinical teams to promote complete and accurate documentation.
  • Ensure documentation supports appropriate MS-DRG and APR-DRG assignment.
  • Assist with reducing denials through accurate clinical documentation and physician education.
  • Monitor documentation trends and identify opportunities for process improvement.
  • Participate in physician education initiatives related to documentation best practices.
  • Maintain productivity and quality standards established by the client.
  • Stay current on regulatory requirements, coding guidelines, and CDI best practices.
  • Assist leadership with special projects and additional duties as assigned.
Required Experience
  • Active RN license
  • Acute Care Hospital CDI experience required
  • Experience performing concurrent inpatient chart reviews
  • Experience writing compliant physician queries
  • Strong understanding of clinical documentation improvement principles
  • Knowledge of MS-DRGs, APR-DRGs, Severity of Illness (SOI), and Risk of Mortality (ROM)
  • Experience collaborating with physicians and interdisciplinary teams
Preferred Experience
  • CCDS and/or CDIP certification
  • Strong understanding of ICD-10-CM/PCS coding guidelines
  • Experience with mortality reviews, quality initiatives, and denial prevention
  • Experience with Epic, Cerner, Meditech, or other major EMR systems
 
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About Vertek Solutions

Sourced by ZipRecruiter

Vertek Solutions is a boutique staffing firm that specializes in recruiting top level IT talent who can enhance our clients’ teams. Our team works every day to foster relationships with both our consultants and clients to understand their needs and ensure that we are providing a solution that is mutually beneficial.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Franklin, TN, US

Year founded

2006

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