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Remote Hca Utilization Review Jobs in Atlanta, GA

YO AI Labs

Hospitalist Physician - Remote

Atlanta, GA · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

Elevance Health

Med Mgmt Nurse (contract)

Decatur, GA · Remote

... utilization review, or managed care experience; or any combination of education and experience ... Remote, work from home Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as ...

Integrated Resources INC

Case Manager

Alpharetta, GA · Remote

$19.50 - $25.25/hr

... reviews utilization of mental health and substance abuse services provided in inpatient and ... The Alpharetta, GA candidate will also have the ability to work remote. This is an inbound ...

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All JobsHca Utilization Review JobsRemote Hca Utilization Review JobsRemote Hca Utilization Review Jobs in Atlanta, GA

Remote Hca Utilization Review information

See Atlanta, GA salary details

$20

$40

$66

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

As of Sep 3, 2026, the average hourly pay for remote hca utilization review in Atlanta, GA is $40.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $46.68 per hour, depending on experience, location, and employer.

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 Atlanta, GA?

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

What job categories do people searching Remote Hca Utilization Review jobs in Atlanta, GA look for?

The top searched job categories for Remote Hca Utilization Review jobs in Atlanta, GA are:

What cities near Atlanta, GA are hiring for Remote Hca Utilization Review jobs?

Cities near Atlanta, GA 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 Atlanta, GA as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $84,574 per year, or $40.7 per hour.

Sr Hospitalist Clinical Reviewer - Remote

YO AI Labs

Atlanta, GA • Remote

$70 - $100/hr

Full-time

Posted 12 days ago

Job description

Senior Hospitalist Clinical Reviewer

Job Type: Contractor
Location: Remote

Job Overview

We are seeking experienced Senior Hospitalist Clinical Reviewers to support a high-impact project focused on inpatient clinical quality, documentation accuracy, and medical review. In this role, you will apply your hospitalist expertise and clinical judgment to evaluate inpatient cases, identify complex or ambiguous clinical scenarios, and provide clear, well-reasoned feedback.

This opportunity is ideal for experienced physicians with a strong background in hospital medicine, inpatient quality, medical auditing, clinical documentation, and quality assurance.

Key Responsibilities
  • Review inpatient cases for clinical quality, appropriate care, and documentation accuracy.
  • Evaluate clinical decisions and identify potential quality, documentation, or care concerns.
  • Apply advanced clinical judgment to complex, unusual, or ambiguous inpatient cases.
  • Provide clear and concise explanations supporting clinical review decisions.
  • Assess medical records, clinical documentation, and relevant supporting information.
  • Identify inconsistencies, gaps, or areas requiring clarification within clinical documentation.
  • Apply established clinical standards, guidelines, and quality frameworks when appropriate.
  • Contribute to the development and improvement of clinical review guidelines and quality standards.
  • Collaborate with project teams to resolve challenging clinical cases and review questions.
  • Maintain consistent, accurate, and high-quality review standards across assigned cases.
  • Work independently while meeting project timelines and quality expectations.
Required Qualifications
  • MD or DO degree.
  • 10+ years of attending-level hospitalist experience.
  • Strong experience in inpatient medicine and hospital-based clinical care.
  • Demonstrated experience with inpatient quality, clinical documentation review, medical auditing, or quality assurance.
  • Excellent clinical judgment and ability to evaluate complex or ambiguous cases.
  • Strong written and verbal communication skills.
  • Ability to clearly articulate clinical reasoning and support review decisions.
  • Strong attention to detail and ability to analyze medical records comprehensively.
  • Ability to work independently in a remote environment.
Preferred Qualifications
  • Experience leading or contributing to hospital quality improvement programs.
  • Experience with clinical documentation improvement (CDI).
  • Experience with medical coding, utilization review, or physician audit processes.
  • Experience developing or reviewing clinical quality standards.
  • Familiarity with hospital quality metrics and inpatient quality initiatives.
  • Previous experience mentoring physicians or participating in physician peer review.
Core Skills
  • Inpatient Quality
  • Quality Assurance
  • Medical Auditing
  • Hospital Medicine / Hospitalist Practice
  • Clinical Judgment
  • Clinical Documentation Review
  • Medical Record Review
  • Quality Improvement
  • Critical Thinking
  • Written and Verbal Communication
  • Attention to Detail