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Remote Hca Utilization Review Jobs in Mount Prospect, IL

AltaStaff, LLC

UM Care Review Clinician

Chicago, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

APPRISEMD LLC

Case Preparation Physician

Northbrook, IL · Remote

$28.25/hr

... for utilization review. MD (or equivalent) level training is required but current Board ... This position is remote (work from home) and is part-time, with a focus on weekend hours. Please ...

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Remote Hca Utilization Review information

See Mount Prospect, IL salary details

$21

$42

$68

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

As of Aug 21, 2026, the average hourly pay for remote hca utilization review in Mount Prospect, IL is $42.01, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 job categories do people searching Remote Hca Utilization Review jobs in Mount Prospect, IL look for?

The top searched job categories for Remote Hca Utilization Review jobs in Mount Prospect, IL are:

What cities near Mount Prospect, IL are hiring for Remote Hca Utilization Review jobs?

Cities near Mount Prospect, IL with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you

ABA Utilization Review (UR) Specialist

Spectrum Billing Solutions

Skokie, IL • Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 24 days ago

Job description

​
Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.
We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist external clients in understanding payer requirements for authorizations.
  • Participate in team meetings.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
  • Flexible work environment 
  • Competitive Salary
  • A close-knit team of talented and skilled individuals.
  • Growth opportunities 
  • Benefits – Medical, Dental, Vision
  • Flexible Paid Time Off
  • 401K with Company match
  • Supplemental Benefits
Qualifications:
  • 3-5 years of related ABA and/or Behavioral Health experience.
  • Bachelor’s or master’s degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services.
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​#UtilizationReviewSpecialist | #UtilizationManagementSpecialist | #URSpecialist | #RevenueCycleSpecialist | #InsuranceSpecialist | #URSpecialist | #RevenueCycleUtilizationReviewSpecialist | #ABAUtilizationReviewSpecialist | #ABAUtilizationManagementSpecialist | #ABAURSpecialist | #BehavioralHealthBillingSpecialist 
 

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