Pet Insurance * Employee Assistance Program * Schulte Savings Marketplace Discounts on event ... Review unconstrained demand and provide recommendations for the optimal mix of business. * Review ...
New
Pet Insurance * Employee Assistance Program * Schulte Savings Marketplace Discounts on event ... Review unconstrained demand and provide recommendations for the optimal mix of business. * Review ...
New
IT Helpdesk Specialist - Remote
Louisville, KY · Remote
$20/hr
... Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term ... reviewed using AI tools.
New
IT Helpdesk Specialist - Remote
Louisville, KY · Remote
$20/hr
... Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term ... reviewed using AI tools.
New
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
In-depth knowledge of health insurance; Medicaid and Medicare knowledge is highly desired ... Review basic technology requirements Hours * Choose your own schedule by self-scheduling 30-minute ...
Remote Registered Nurse (RN) Case Manager
Louisville, KY · On-site +1
$50K/yr
... patient's insurance payer to determine coverage benefits, anticipated out-of-pocket costs ... Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case ...
Remote Registered Nurse (RN) Case Manager
Louisville, KY · On-site +1
$50K/yr
... patient's insurance payer to determine coverage benefits, anticipated out-of-pocket costs ... Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case ...
Licensed Clinical Social Worker (LCSW)
Elizabethtown, KY · On-site +1
$115K - $120K/yr
Health Insurance * 401K Plan with 3% Company Match * Remote work environment * Consistent weekday ... review your application.
Licensed Clinical Social Worker (LCSW)
Elizabethtown, KY · On-site +1
$115K - $120K/yr
Health Insurance * 401K Plan with 3% Company Match * Remote work environment * Consistent weekday ... review your application.
Licensed Clinical Social Worker (LCSW)
Elizabethtown, KY · Remote
$115K - $120K/yr
Health Insurance * 401K Plan with 3% Company Match * Remote work environment * Consistent weekday ... review your application.
Licensed Clinical Social Worker (LCSW)
Elizabethtown, KY · Remote
$115K - $120K/yr
Health Insurance * 401K Plan with 3% Company Match * Remote work environment * Consistent weekday ... review your application.
... insure cost effective and efficient utilization of health benefits. * Obtains a thorough and ... Additional Details: * 100% remote . * M-F 8:30 - 5pm ET * Candidates must live within 50 miles of ...
... insure cost effective and efficient utilization of health benefits. * Obtains a thorough and ... Additional Details: * 100% remote . * M-F 8:30 - 5pm ET * Candidates must live within 50 miles of ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Quick apply
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · On-site +1
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Quick apply
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Quick apply
Medical Billing Customer Support 2nd SHIFT REMOTE
Murray, KY · Remote
$13.75 - $17.25/hr
Conducts insurance verification and eligibility for services/products * Conducts patient ... Provides thorough review and Quality Assurance for medical necessity and documentation requirements ...
Remote Insurance Utilization Review information
What is the difference between Remote Insurance Utilization Review vs Remote Claims Reviewer?
| Aspect | Remote Insurance Utilization Review | Remote Claims Reviewer |
|---|---|---|
| Credentials | Typically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professional | Usually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H |
| Work Environment | Remote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of services | Remote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance |
| Industry Usage | Commonly used in healthcare insurance to evaluate medical necessity | Used across insurance sectors to process and validate claims |
Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.
How does a remote insurance utilization review professional collaborate with healthcare providers and insurance companies?
Remote insurance utilization review professionals regularly interact with healthcare providers to gather patient information, clarify treatment plans, and ensure that clinical documentation supports insurance requirements. They also communicate with insurance companies to advocate for patient care, provide necessary justifications, and resolve coverage issues. While the work is done remotely, collaboration typically occurs via secure email, phone calls, and virtual meetings, requiring strong communication and organizational skills to ensure timely and accurate exchange of information.
What are remote insurance utilization review jobs?
Remote insurance utilization review jobs involve evaluating medical records and treatment plans to determine whether healthcare services are medically necessary and covered by a patient’s insurance plan. Professionals in these roles, often nurses or other healthcare specialists, work from home and communicate with healthcare providers, insurance companies, and patients. Their main goal is to ensure that patients receive appropriate care while also helping insurance companies manage costs and comply with regulations.
What are the key skills and qualifications needed to thrive as a Remote Insurance Utilization Review Specialist, and why are they important?
To thrive as a Remote Insurance Utilization Review Specialist, you need a strong understanding of medical terminology, clinical guidelines, and insurance policies—usually supported by a nursing or health-related degree and relevant licensure. Familiarity with electronic medical record (EMR) systems, insurance claims platforms, and utilization review software is essential. Strong analytical skills, attention to detail, and effective written communication are crucial soft skills for this role. These competencies ensure accurate case evaluations, compliance with regulations, and clear communication between healthcare providers and insurers.
What are popular job titles related to Remote Insurance Utilization Review jobs in Kentucky? For Remote Insurance Utilization Review jobs in Kentucky, the most frequently searched job titles are:
- Manager Utilization Management
- Remote Prior Authorization Nurse
- Part Time Utilization Review Nurse
- Overnight Physician Case Reviewer
- Non Exempt No Experience Utilization Management Nurse
- Remote Medical Librarian
- Evening Optum Health Utilization Review
- Utilization Management
- Flex Schedule Remote Utilization Review Nurse
- Physician Advisor Utilization Review
What job categories do people searching Remote Insurance Utilization Review jobs in Kentucky look for? The top searched job categories for Remote Insurance Utilization Review jobs in Kentucky are:
- Lpn Utilization Review Work From Home
- Remote Surrogate Case Manager
- Commission Authorization Utilization Review Bcba
- Afternoon Remote Case Manager
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- Night Shift Optum Utilization Review
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- Remote Aetna Utilization Review
- Utilization Review
What cities in Kentucky are hiring for Remote Insurance Utilization Review jobs? Cities in Kentucky with the most Remote Insurance Utilization Review job openings:
Full-time
Medical, Life, Retirement, PTO
Posted 5 days ago
New
Job description
This is a remote position that supports a portfolio of hotels located throughout the West Coast region. Candidates must be able to work effectively with teams across the West Coast and accommodate the region's business hours as needed.
Schulte Hospitality Groupis seeking a dynamic, service-oriented AreaDirector of Revenue Management to join our team! Schulte Hospitality Group is an organization whose success is rooted in its service culture. Our mission is to exude hospitality, be respectful and authentic, prioritize the needs of our internal and external stakeholders above our own, and continuously strive to make a positive impact in all we do. We are passionate hoteliers eager to add like-minded people to our rapidly growing team!
What's in it for you? When you join Schulte Hospitality Group, you'll be part of a team committed to an inclusive, employee-focused workplace that is invested in your development. We want you to feel engaged, empowered, and excited to grow with us. After all, we believe our greatest and most valuable asset is our people! Schulte Hospitality Group provides a rewarding, fun and flexible work environment, exciting perks, an atmosphere designed to encourage and promote career growth within the company and a robust benefit package including, but not limited to:
- Work Today, Get Paid today, with Daily Pay!
- Free Telemedicine and Virtual Mental Health care access for All Associates starting day one!
- Multiple Health Insurance and Life Insurance options
- 401k Plan + Company Match
- Paid Parental Leave
- Paid Time Off
- Holiday Pay
- Pet Insurance
- Employee Assistance Program
- Schulte Savings Marketplace Discounts on event tickets, electronics, gym memberships + more!
Our Company: Schulte Hospitality Group is leading third-party management company with deep, multi-generational experience in all facets of the hospitality industry. We are a diverse team of innovative hoteliers and restauranteurs operating more than 200 locations across 38 states and 3 countries. Our portfolio includes a wide array of reputable brands like Marriott, Hilton, IHG and Hyatt as well as many unique, independent, boutique and lifestyle properties and restaurants.
JOB DUTIES AND RESPONSIBILITIES
- Grow RevPAR and RevPAR Index.
- Daily room inventory management
- Monitor hotel and competitor rates, availability, strategies, and seasonality and adjust pricing accordingly.
- Review unconstrained demand and provide recommendations for the optimal mix of business.
- Review production of negotiated accounts with hotel's sales leader pricing for Group and Transient and by segment.
- Analyze local events and project their impact.
- Prepare weekly and monthly forecasts.Lead the weekly strategy meeting; reviewing prior week's decisions to evaluate effectiveness; following up on assigned tasks of others; critiquing year over year variances by segment; etc.
- Conduct displacement analysis with group or contract.
- Monitor online reviews.
- Review STR reports and provide analysis of hotel performance against their comp set.
- Utilize systems and resources including One Yield, MRDW, HPP, and CI/TY.
- Review additional tools such as Hotelligence or Demand Positioning reports.Assist with the preparation of the annual rooms revenue budget and business plans.
- Ensure distribution channels have accurate content and pricing.
- Develop relationships with the Online Travel Agencies (OTA) or Third Party Intermediaries (TPI) to maximize opportunities through these channels.
- Assist with internet marketing campaigns, GDS advertising, etc.Assist in developing the hotel managers so that they become proficient with revenue management.
- Work with the hotel to ensure coding and tracking is performed correctly.
- Perform various other duties as assigned to meet business objectives
EDUCATION AND EXPERIENCE
- Hotel Management, Businessand/or related degree preferred
- Minimum of two (2) years revenue management experience with multiple systems
KNOWLEDGE, SKILLS AND ABILITIES
- Exceptional service and customer relations skills with ability to foster effective relationships with staff, management and clientele.
- Excellent verbal and written communication skills and ability to communicate ideas and concepts.
- Highly proficient in computersincluding, but not limited to Internet, Microsoft Office programs and hotel sales related programs.
Strong facilitation and presentation skills.
*The hiring process may consist of a phone interview, manager(s) interview, drug screen, background check, reference checks, and potential employment assessment. This job description is only intended to provide a general description of the benefits and compensation applicable to this position. Paid Time Off (PTO) is available for eligible associates in accordance with the Company's Paid Time Off policy. Specific compensation and benefit details will be discussed during the interview process.
*Schulte Hospitality Group is an Equal Opportunity Employer.
About Schulte
Sourced by ZipRecruiter
Schulte Hospitality Group is a division of Schulte Companies, a leading third-party management company with deep, multi-generational experience in all facets of the hospitality industry. We are a diverse team of innovative hoteliers and restauranteurs operating more than 200 locations across 38 states and 3 countries. Our portfolio includes a wide array of reputable brands like Marriott, Hilton, IHG and Hyatt as well as many unique, independent, boutique and lifestyle properties and restaurants.
Industry
Hospitality services
Company size
10,000+ Employees
Headquarters location
Louisville, KY, US