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How much do remote occupational therapy utilization review jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for remote occupational therapy utilization review in the United States is $45.37, according to ZipRecruiter salary data. Most workers in this role earn between $38.70 and $50.96 per hour, depending on experience, location, and employer.

What is a Remote Occupational Therapy Utilization Review job?

A Remote Occupational Therapy Utilization Review job involves evaluating occupational therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review documentation, provide recommendations, and collaborate with healthcare providers and insurance companies. Their main goal is to ensure appropriate care while preventing unnecessary costs. Strong analytical skills and knowledge of occupational therapy practices and insurance regulations are essential for this role.

What are some common daily tasks and responsibilities for someone in a Remote Occupational Therapy Utilization Review position?

Professionals in Remote Occupational Therapy Utilization Review primarily review clinical documentation to determine the medical necessity and appropriateness of occupational therapy services. Typical daily tasks include analyzing therapy notes, applying payer criteria to case reviews, communicating with providers for clarifications, and documenting decisions within electronic systems. You may also participate in team meetings, provide feedback to therapy staff, and stay updated on changing regulations or insurance policies. This role requires a balance of independent work and frequent collaboration with other utilization reviewers, case managers, and healthcare providers to ensure the highest quality of care and compliance.

What are the key skills and qualifications needed to thrive in the Remote Occupational Therapy Utilization Review position, and why are they important?

To thrive as a Remote Occupational Therapy Utilization Review professional, you need a background in occupational therapy, solid clinical assessment skills, and familiarity with medical necessity criteria such as Medicare or insurance guidelines. Experience using electronic medical record (EMR) systems, utilization review software, and knowledge of relevant certifications like OTR/L or CHT are typically required. Attention to detail, critical thinking, and strong written communication skills are highly valued in this role. These abilities are crucial to making accurate determinations, maintaining compliance, and effectively collaborating with healthcare teams and insurers from a remote setting.

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Remote Occupational Therapy Utilization Review jobs near you
Infographic showing various Remote Occupational Therapy Utilization Review job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $94,375 per year, or $45.4 per hour.

Utilization Review Coordinator

Prosperous Health

Los Angeles, CA • Remote

Full-time

Medical, PTO

Posted 4 days ago

Be an early applicant

Job description

Salary: $70,000-$80,000 Anual DOE

Job Title: Utilization Review (UR) Coordinator

Company:Prosperous Billing / Prosperous Health
Department:Revenue Cycle / Clinical Operations Support
Employment Type:Full-Time (Remote or Hybrid, as applicable)

Position Summary

The Utilization Review (UR) Specialist at Prosperous Billing is responsible for securing, maintaining, and maximizing insurance authorizations for behavioral health and substance use disorder treatment services. This role serves as a key liaison between clinical teams and insurance payers to ensure medical necessity is clearly documented, authorizations are obtained in a timely manner, and continued stay approvals are optimized to support high-quality patient care and strong revenue cycle performance.

Key Responsibilities

Authorization & Continued Stay Management

  • Obtain initial and concurrent authorizations for detox, residential, PHP, IOP, and outpatient levels of care
  • Conduct continued stay reviews with insurance payers according to payer-specific timelines
  • Proactively track authorization expirations and submit reviews to prevent lapses in coverage or avoidable denials

Clinical Documentation & Medical Necessity

  • Review clinical documentation to ensure alignment with medical necessity criteria (ASAM, MCG, InterQual, and payer-specific guidelines)
  • Collaborate with clinical staff to obtain complete, accurate, and timely documentation
  • Summarize clinical information clearly and professionally for payer utilization reviews

Payer Communication & Appeals

  • Communicate directly with insurance reviewers, care managers, and medical directors
  • Participate in peer-to-peer reviews when necessary
  • Support appeals for denied or reduced authorizations through clinical summaries and supporting documentation

Revenue Cycle & Compliance Support

  • Maintain accurate authorization records within EMR and billing systems
  • Ensure compliance with payer contracts, regulatory requirements, and internal policies
  • Identify authorization-related risks and trends that may impact reimbursement or revenue integrity

Collaboration & Reporting

  • Work closely with billing, admissions, and clinical teams to ensure smooth authorization workflows
  • Provide regular reporting on authorization status, denials, approvals, and trends
  • Support ongoing process improvements to increase authorization success rates and reduce denials

Qualifications

Required

  • 2+ years of Utilization Review experience in behavioral health and/or substance use treatment
  • Strong working knowledge of ASAM criteria and medical necessity standards
  • Experience obtaining authorizations for residential and outpatient levels of care
  • Excellent verbal and written communication skills
  • Strong organizational skills with high attention to detail
  • Ability to manage multiple cases and deadlines simultaneously

Preferred

  • Clinical background (RN, LCSW, LMFT, LPCC, or equivalent licensure)
  • Experience working with commercial insurance payers and Medicaid plans
  • Familiarity with EMR systems and insurance payer portals
  • Prior experience in a billing, revenue cycle, or healthcare operations environment

Key Competencies

  • Medical necessity advocacy
  • Payer communication and negotiation
  • Clinical-to-financial alignment
  • Time management and prioritization
  • Critical thinking and problem-solving
  • Professional judgment and confidentiality

Compensation & Benefits

  • Competitive salary (commensurate with experience)
  • Health insurance coverage with50% employer contribution
  • Paid Time Off (PTO)
  • Paid holidays
  • Remote or hybrid work flexibility (role dependent)

Performance Metrics (Success Indicators)

  • Authorization approval rate
  • Timeliness of initial and continued stay submissions
  • Reduction in authorization-related denials
  • Accuracy and completeness of documentation
  • Responsiveness and collaboration with internal teams