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Remote Chiropractic Utilization Review Jobs in Springfield, IL

Remote Chiropractic Utilization Review information

See Springfield, IL salary details

$21

$41

$68

How much do remote chiropractic utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for remote chiropractic utilization review in Springfield, IL is $41.91, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

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 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 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 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 are popular job titles related to Remote Chiropractic Utilization Review jobs in Springfield, IL? For Remote Chiropractic Utilization Review jobs in Springfield, IL, the most frequently searched job titles are:
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What cities near Springfield, IL are hiring for Remote Chiropractic Utilization Review jobs? Cities near Springfield, IL with the most Remote Chiropractic Utilization Review job openings:
Infographic showing various Remote Chiropractic Utilization Review job openings in Springfield, IL as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,164 per year, or $41.9 per hour.

Medicaid Business/QA Analyst

MSR Technology Group

Springfield, IL • Remote

Contractor

Re-posted 28 days ago


Job description

Medicaid Business / QA Analyst
  • 7–12+ Month Contract | Remote | No ThirdParty Firms | Medicaid SME Required
  • Candidates with previous State Medicaid program experience will be given strong consideration.
  • Drug screen and background check required as part of onboarding
Position Summary
The Medicaid Business/QA Analyst serves as a subject matter expert (SME) for Medicaid data and processes while performing quality assurance testing within a large-scale Enterprise Data Warehouse (EDW) environment. This position combines program knowledge—eligibility, claims, encounters, provider enrollment, managed care, and reporting—with QA discipline to ensure accuracy, completeness, and usability of EDW deliverables such as data marts, inbound source data loads, outbound extracts, reporting outputs, and operational dashboards.
Key Responsibilities1. Business SME – Medicaid Data & Processes
  • Interpret Medicaid data elements, business rules, and program logic for EDW initiatives.
  • Review inbound data from core systems (eligibility, provider, claims, managed care) for accuracy and mapping alignment.
  • Validate outbound extracts and reporting outputs for accuracy, timeliness, and format requirements.
  • Support development of data marts across eligibility, claims/utilization, provider, managed care, LTSS, and behavioral health.
2. QA Planning & Execution
  • Develop QA plans, scenarios, and test cases aligned to business rules.
  • Perform data reconciliation between source files and EDW target tables.
  • Validate transformations, aggregations, and derived fields.
  • Participate in User Acceptance Testing (UAT) with business stakeholders.
3. Data Quality & Issue Resolution
  • Identify data anomalies, mapping issues, and business rule gaps; work with data engineering and ETL teams to resolve.
  • Ensure referential integrity across eligibility, claims, provider, and plan datasets.
  • Define business data quality rules for ongoing monitoring.
  • Track and document issues in defect management tools.
4. Collaboration & Documentation
  • Work with business stakeholders, vendors, and technical teams to validate requirements and deliverables.
  • Review BRDs, mapping documentation, and data models for accuracy.
  • Maintain QA evidence, testing documentation, and business rule records.
  • Support knowledge transfer related to Medicaid data usage within the EDW.
Required Skills & Qualifications
  • Strong Medicaid business knowledge (eligibility, claims, encounters, provider, managed care).
  • Experience working with EDW environments, including inbound feeds, staging layers, integration layers, data marts, and outbound extracts.
  • Proficiency with SQL for validation and reconciliation.
  • Experience in data warehouse QA/testing, including validating data transformations and dimensional models.
  • Ability to translate Medicaid program rules into testable acceptance criteria.
  • Familiarity with HIPAA compliance and PHI guidelines.
  • Excellent analytical, documentation, and communication skills.
Preferred Qualifications
  • Experience with Medicaid EDW or MMIS modernization projects.
  • Familiarity with provider handbooks, policy documentation, or administrative rules.
  • Experience with managed care data (capitation, encounters, member assignments).
  • Experience validating dashboards or reports in tools such as Tableau, Power BI, or Cognos.
  • Background in data governance or metadata management.