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Remote Behavioral Health Utilization Review Jobs in Wisconsin

Harris

Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client ...

Harris

Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client ...

Harris

Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client ...

Harris

Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client ...

Bcbsa

$155K - $175K/yr

... in healthcare, pharmacy benefit management (PBM), utilization management, pharmaceutical ... Work is generally performed in a remote setting. #LI-Remote $155,000.00 - $175,000.00 This is the ...

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Remote Behavioral Health Utilization Review information

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 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 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 most commonly searched types of Behavioral Health Utilization Review jobs in Wisconsin?

The most popular types of Behavioral Health Utilization Review jobs in Wisconsin are:

What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Wisconsin?

For Remote Behavioral Health Utilization Review jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Remote Behavioral Health Utilization Review jobs in Wisconsin look for?

The top searched job categories for Remote Behavioral Health Utilization Review jobs in Wisconsin are:

What cities in Wisconsin are hiring for Remote Behavioral Health Utilization Review jobs?

Cities in Wisconsin 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 Wisconsin as of August 2026, with employment types broken down into 2% As Needed, 78% Full Time, 15% Part Time, and 5% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Medical Coder - Remote Nationwide

UnitedHealth Group

Wausau, WI • On-site, Remote

$20 - $36/hr

Full-time

Retirement

Posted 4 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

190th of 888 rated healthcare providers

Job description

REMOTE NATIONWIDE
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required.
Hours: This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm.
We offer 2-3 weeks of paid training. The hours during training will be 7am to 3:30 pm CST, Monday - Friday.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Receive assigned provider inquiries and perform a code review on both professional and facility claims
  • Make determinations on cases after a coding review is complete
  • Review various edits on cases and complete audit of medical records received to ensure proper editing is applied
  • Review medical charts electronically
  • Abstract and code diagnosis and procedures from the medical record
  • Review and supply procedure and diagnosis codes for benefit coding requests
  • Document requested information from the medical record
  • Perform ongoing analysis of medical record charts for the appropriate coding compliance

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • High School Diploma / GED
  • Active coding certification to include one of the following: CPC, CPC-A, COC, CCS, CCS-P, CCA, RHIA or RHIT
  • 1+ years of medical coding experience with CPT
  • 1+ years of medical coding experience with ICD-10

Preferred Qualifications:
  • AAPC credentials
  • 1+ years of facility-based coding experience
  • 1+ years of managed care experience
  • Pharmacology knowledge

Telecommuting Requirements:
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO, #GREEN

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