Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Quick apply
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
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Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Baltimore, MD · Remote
$24.67/hr
Remote - offsite. Must work east coast hours. Hours: 8 hours per day, 40 hours per week. 5 days on ... Review authorization requests for initial determination and triage for clinical review and ...
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Baltimore, MD · Remote
$24.67/hr
Remote - offsite. Must work east coast hours. Hours: 8 hours per day, 40 hours per week. 5 days on ... Review authorization requests for initial determination and triage for clinical review and ...
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Quick apply
Remote -- client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected ... Review incoming authorization requests for initial determination and/or triage items for clinical ...
Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative ... Reviews authorization requests for initial determination and/or triages for clinical review and ...
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Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative ... Reviews authorization requests for initial determination and/or triages for clinical review and ...
Those fully remote associates residing in states where service is required by contract, law, or ... Strong understanding of utilization review processes, including medical necessity criteria, care ...
Those fully remote associates residing in states where service is required by contract, law, or ... Strong understanding of utilization review processes, including medical necessity criteria, care ...
Baltimore, MD · Remote
$46 - $51/hr
Reviews ABA treatment requests (initial, concurrent, and retrospective) to determine medical ... Prior experience in utilization management, care management, or payer-side review of ABA services.
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Baltimore, MD · Remote
$46 - $51/hr
Reviews ABA treatment requests (initial, concurrent, and retrospective) to determine medical ... Prior experience in utilization management, care management, or payer-side review of ABA services.
Baltimore, MD · Remote
$46 - $51/hr
Pay Range: $46.76hr - $51.76hr Requirement/Must Have: * RN license, utilization management ... Applies sound clinical knowledge and judgment throughout the review process. Coordinates non-par ...
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Baltimore, MD · Remote
$46 - $51/hr
Pay Range: $46.76hr - $51.76hr Requirement/Must Have: * RN license, utilization management ... Applies sound clinical knowledge and judgment throughout the review process. Coordinates non-par ...
Baltimore, MD · On-site +1
Certification in Case Management (CCM), Utilization Review Accreditation Commission (URAC), or related credentials is a plus. Working conditions This job operates in a remote location from your home ...
Baltimore, MD · On-site +1
Certification in Case Management (CCM), Utilization Review Accreditation Commission (URAC), or related credentials is a plus. Working conditions This job operates in a remote location from your home ...
Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
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Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
Baltimore, MD · Remote
Remote Job Duration: Contract / FTE Client: Federal Criteria- Need US citizenship because of ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
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Baltimore, MD · Remote
Remote Job Duration: Contract / FTE Client: Federal Criteria- Need US citizenship because of ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
Fairfax, VA · Remote
$80 - $110/hr
BCBA (Board Certified Behavior Analyst) - Part-time $80110/hr Flexible Schedule Hybrid (Remote + In ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...
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Fairfax, VA · Remote
$80 - $110/hr
BCBA (Board Certified Behavior Analyst) - Part-time $80110/hr Flexible Schedule Hybrid (Remote + In ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...
Baltimore, MD · Remote
While this position is remote, the incumbent will be expected to come into a CareFirst location ... Utilization Review, Disease Management or other direct patient care experience. Preferred ...
Baltimore, MD · Remote
While this position is remote, the incumbent will be expected to come into a CareFirst location ... Utilization Review, Disease Management or other direct patient care experience. Preferred ...
Baltimore, MD · On-site +1
$80K - $95K/yr
A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...
Baltimore, MD · On-site +1
$80K - $95K/yr
A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...
A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...
A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...
... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...
... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...
Baltimore, MD · Remote
$19 - $24/hr
Reviews authorization requests for initial determination and/or triages for clinical review and resolution. * Provides general support and coordination services for the department including but not ...
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Baltimore, MD · Remote
$19 - $24/hr
Reviews authorization requests for initial determination and/or triages for clinical review and resolution. * Provides general support and coordination services for the department including but not ...
$22.12 - $26.59
2% of jobs
$26.59 - $31.06
9% of jobs
$34.12 is the 25th percentile. Wages below this are outliers.
$31.06 - $35.54
21% of jobs
The median wage is $39.16 / hr.
$35.54 - $40.01
23% of jobs
$40.01 - $44.48
13% of jobs
$47.96 is the 75th percentile. Wages above this are outliers.
$44.48 - $48.96
10% of jobs
$48.96 - $53.43
8% of jobs
$53.43 - $57.90
5% of jobs
$57.90 - $62.37
5% of jobs
$62.37 - $66.85
2% of jobs
$66.85 - $71.32
2% of jobs
$22
$43
$71
| Aspect | Remote Chiropractic Utilization Review | Remote Chiropractic Billing Specialist |
|---|---|---|
| Primary Role | Assessing medical necessity and appropriateness of chiropractic treatments | Managing billing, coding, and insurance claims for chiropractic services |
| Required Credentials | Chiropractic license, possibly certifications in utilization review | Medical billing certifications, knowledge of coding and insurance policies |
| Work Environment | Remote, healthcare or insurance companies | Remote, healthcare providers or billing companies |
| Industry Usage | Used by insurance companies and healthcare organizations to approve treatments | Used 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.

Contractor
Medical, Dental, Vision, Life, Retirement
Re-posted 4 days ago
UTILIZATION MANAGEMENT COORDINATOR
Location: Remote — client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected extension possible) Schedule: 40 hours/week — must include a weekend day Pay (W2): USD 24.70/H
JOB OVERVIEW
In this role, you’ll support Utilization Management (UM) clinical teams by handling non-clinical administrative work tied to pre-service authorization, utilization review support, care coordination workflows, and quality-of-care processes. You’ll help manage authorization intake, documentation, and provider/member support—while working in a fast-paced environment where schedule flexibility (including weekends) is required.
WHAT YOU’LL DO
Provide member/provider administrative support such as benefit verification, authorization creation/management, claims inquiries, and case documentation.
Review incoming authorization requests for initial determination and/or triage items for clinical review and resolution.
Support day-to-day coordination for the department, including answering/responding to phone calls, taking messages, and responding to basic inquiries.
Research information and assist with issue resolution and operational problem-solving.
Assist with reporting, data tracking, and organizing/disseminating information (including Continuity of Care processes and tracking Peer-to-Peer reviews).
REQUIRED QUALIFICATIONS
High School Diploma (or equivalent)
3+ years of experience in healthcare claims/service areas and/or healthcare office/administrative support
Ability to work effectively within a multidisciplinary team (internal and external partners)
Strong communication, organization, and customer service skills
Strong attention to detail with sound judgment and decision-making
Comfortable with web-based tools and Microsoft Office (Word, Excel, PowerPoint)
NICE TO HAVE
Knowledge of CPT and ICD-10 coding / medical terminology used in managed care
Experience in a managed care environment (health plan / UM support)
Phone-heavy/customer support experience
Experience with Medicaid/Medicare (government programs)
Exposure to tools such as Facets, Guiding Care, and/or NICE CXone
System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
#M-M2 #LI-
Ref: #851-Rockville-S1