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Remote Hca Utilization Review Jobs in Missouri (NOW HIRING)

Berkley

Claims Analyst

Chesterfield, MO · Remote

Establishing, reviewing and adjusting case reserves in a timely manner within proper authority ... Office and remote work environment Travel required up to 25% to 35% based on customer, broker, and ...

New

Berkley

Claims Analyst

Chesterfield, MO · Remote

Establishing, reviewing and adjusting case reserves in a timely manner within proper authority ... Additional RequirementsOffice and remote work environment Travel required up to 25% to 35% based on ...

Dell, Inc.

Principal Engineer, Service Delivery

MO · On-site +1

Join us as a Principal Service Delivery Engineer on our remote Service Delivery team to do the best ... Peer Reviews and Change Advisory Board presentations, ensuring review packages are complete ...

Imperial PFS

Analytics Engineer I

Kansas City, MO · On-site +1

$111K - $134K/yr

Kansas City, MO (4 days in-office, 1 day remote) Experience Level: Mid-level (2-4 years) Department ... Monitor and improve pipeline efficiency and resource utilization Technical Documentation * Create ...

Imperial PFS

Analytics Engineer I

Kansas City, MO · On-site +1

$111K - $134K/yr

Kansas City, MO (4 days in-office, 1 day remote) Experience Level: Mid-level (2-4 years) Department ... Monitor and improve pipeline efficiency and resource utilization Technical Documentation * Create ...

Parsons

Principal Roadway Engineer

Kansas City, MO · On-site +1

$103K - $181K/yr

Parsons is now hiring a Principal Roadway Engineer to join remote Kansas City team! This is a ... Reviewing work produced to ensure that applicable codes, standards, and procedures are followed and ...

Uber Technologies, Inc.

Monitor partner performance, utilization, and business health, and use data to identify risks and ... Prepare executive-ready updates, business reviews, and recommendations on partner strategy and ...

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Remote Hca Utilization Review information

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Missouri?

For Remote Hca Utilization Review jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Missouri look for?

The top searched job categories for Remote Hca Utilization Review jobs in Missouri are:

What cities in Missouri are hiring for Remote Hca Utilization Review jobs?

Cities in Missouri with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Missouri as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% Remote job distribution.

Revenue Cycle Medical Billing Appeal Resource Utilization Clinical Writer

Air Evac Lifeteam

West Plains, MO • On-site, Remote

$33.65/hr

Full-time

Re-posted 2 days ago

Job description


Revenue Cycle Medical Billing Clinical Appeal Writer
(must currently be a licensed RN)
Location: Remote or On-Site, United States
Hourly Compensation: $33.65
(this position is bonus eligible)
Work Schedule: Full Time
Job Summary
The Clinical Appeal Writer audits medical necessity justification for air transport evaluation and submission of all medical necessity appeals for government payors. They utilize clinical flight experience, established clinical standards and protocols, to validate air medical necessity and appeal payment denials.
Essential Functions/ Duties
  • Conducts audits of the medical necessity appeals for all payor sources in the role of advocate for the patient and GMR.
  • Ensures appeal timelines are met by moving the assigned book of business through the appeals process and updates appeals database.
  • Works with fixed deadlines and demonstrates willingness to meet and exceed performance metrics.
  • Works with the Appeal team to determine the best approach to each clinical denial in order to maximize claim reimbursement and minimize the financial risk to patients and GMR.
  • Maintains strict confidentiality of all protected health information and cooperates fully with all information security guidelines related to the scope of work.

Qualifications
Required Experience
  • Minimum of five years in Emergency department (ED), Intensive Care Unit (ICU), flight or ambulance experience or job experience equivalent
  • Supervisory/leadership experience preferred (i.e.: team leader, FTO, charge nurse, preceptor, educator, etc.)
  • Proficient in Word, Excel, Office 365

Education/Licensure
  • Current RN licensure, is required
  • Bachelor's degree in nursing or equivalent, is preferred
  • CFRN, CEN or CCRN, is preferred

Skills
  • Excellent written communication skills
  • Ability to define and identify problems, collect data, establish facts, and draw valid conclusions
  • Ability to respond to inquiries or complaints from customers in a positive and productive manner
  • Ability to calculate numbers, correct entries, and post to records
  • Ability to gather data from hospital and EMS charts, phone calls, emails, colleagues, and internet research, then compile information and prepare reports and letters
  • Ability to use independent judgment and to manage and impart confidential information
  • Ability to research local EMS protocols, hospital referrals, and standards of care.
  • Ability to review clinical charts and development of constructive feedback

Why Choose Air Evac Lifeteam? As a leader in helicopter air ambulance services, Air Evac Lifeteam is one of Global Medical Response's (GMR) family of solutions. Our GMR teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. View the stories on how our employees provide care to the world at www.AtaMomentsNotice.com.
GMR's Core Behaviors-keep care at the center, raise your hand, seek to understand, find a way together and be accountable-unite our teams and set us apart in emergency medical services.
EEO Statement
Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
More Information about this Job
Check out our careers site benefits page to learn more about our benefit options.

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