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Remote Chiropractic Utilization Review Jobs in California

3B Healthcare, Inc.

RN - Utilization Review

Torrance, CA · Remote

Registered Nurse - Utilization Review (Remote)This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient ...

New

3B Healthcare, Inc.

RN - Utilization Review

Torrance, CA · Remote

Registered Nurse - Utilization Review (Remote)This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient ...

New

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...

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Remote Chiropractic Utilization Review information

What is a remote chiropractic utilization review?

A Remote Chiropractic Utilization Review is a process where licensed chiropractors or healthcare professionals assess the necessity, efficiency, and appropriateness of chiropractic care provided to patients, but do so remotely—often from home or a centralized office. This review typically involves examining patient records, treatment plans, and billing information to ensure that care meets established clinical guidelines and insurance requirements. The goal is to improve patient outcomes, prevent unnecessary treatments, and ensure that services billed to insurance are medically necessary. Remote reviews use secure online systems and may require coordination with treating chiropractors, insurance companies, and other healthcare providers.

What are the key skills and qualifications needed to thrive as a remote chiropractic utilization review specialist?

To thrive as a Remote Chiropractic Utilization Review specialist, you need a Doctor of Chiropractic degree, a valid state license, and comprehensive knowledge of chiropractic procedures and medical necessity guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certification such as Certified Professional Utilization Review (CPUR) is often required. Strong analytical skills, attention to detail, and effective communication are crucial for evaluating clinical documentation and collaborating with providers. These skills ensure accurate, evidence-based reviews that support appropriate patient care and compliance with insurance standards.

What are some common challenges faced in a remote chiropractic utilization review role, and how can they be managed?

One of the main challenges in a remote Chiropractic Utilization Review role is effectively evaluating clinical documentation to ensure treatment appropriateness without direct patient interaction. Communication with providers can sometimes be limited or delayed, requiring strong written and verbal skills to clarify cases efficiently. Managing time and workflow independently is crucial, as the workload may fluctuate throughout the week. Staying updated with payer guidelines and evidence-based practices is also essential for accurate reviews. Building strong virtual collaboration with team members and providers can help overcome these challenges and maintain high-quality standards.

What is the difference between Remote Chiropractic Utilization Review vs Remote Chiropractic Billing Specialist?

AspectRemote Chiropractic Utilization ReviewRemote Chiropractic Billing Specialist
Primary RoleAssessing medical necessity and appropriateness of chiropractic treatmentsManaging billing, coding, and insurance claims for chiropractic services
Required CredentialsChiropractic license, possibly certifications in utilization reviewMedical billing certifications, knowledge of coding and insurance policies
Work EnvironmentRemote, healthcare or insurance companiesRemote, healthcare providers or billing companies
Industry UsageUsed by insurance companies and healthcare organizations to approve treatmentsUsed by billing companies and healthcare providers for claims processing

Remote Chiropractic Utilization Review focuses on evaluating the medical necessity of chiropractic treatments, while Remote Chiropractic Billing Specialist handles billing, coding, and insurance claims. Both roles are remote and require healthcare knowledge, but they serve different functions within the chiropractic industry.

What are the most commonly searched types of Chiropractic Utilization Review jobs in California?

The most popular types of Chiropractic Utilization Review jobs in California are:

What are popular job titles related to Remote Chiropractic Utilization Review jobs in California?

For Remote Chiropractic Utilization Review jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Chiropractic Utilization Review jobs in California look for?

The top searched job categories for Remote Chiropractic Utilization Review jobs in California are:

What cities in California are hiring for Remote Chiropractic Utilization Review jobs?

Cities in California with the most Remote Chiropractic Utilization Review job openings:

Remote Chiropractic Utilization Review jobs near you
Infographic showing various Remote Chiropractic Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

RN - Utilization Review

3B Healthcare, Inc.

Torrance, CA • Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Registered Nurse – Utilization Review (Remote)This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable).InterQual experience is mandatory; candidates without this will not be considered.Proficient in Epic, with recent use within the last 6–12 months.Experience working with HMOs, IPAs, and similar managed care organizations.Strong knowledge of Medicare regulations and associated utilization management processes, including:Condition Code 44 (CC44)Advance Beneficiary Notices (ABNs)Hospital-Issued Notices of Noncoverage (HINNs)Medicare Coverage Status Notices (MCSNs)

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