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Remote Physical Therapy Utilization Review Jobs (NOW HIRING)

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing ... Active CPR certification Physical Requirements: * Ability to sit at a desk and work on a computer ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Cobalt Benefits Group

Utilization Review Nurse

As a Utilization Review Nurse (UR Nurse), you'll play an important role in helping us offer ... Work Environment & Physical Demands * Prolonged periods of sitting may be required. * Regular use ...

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Remote Physical Therapy Utilization Review information

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

As of Jul 4, 2026, the average hourly pay for remote physical therapy utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

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

To excel as a Remote Physical Therapy Utilization Review professional, you need a background in physical therapy (often with licensure), clinical knowledge, and experience in utilization management or case review. Familiarity with electronic health records (EHR), claims management systems, and industry tools such as InterQual or Milliman criteria is typically required. Strong analytical skills, attention to detail, effective written communication, and the ability to work independently are valuable soft skills for this position. These abilities are crucial for accurately evaluating medical necessity, facilitating reimbursement, and ensuring compliance with healthcare guidelines in a remote setting.

What does a typical day look like for someone in a Remote Physical Therapy Utilization Review role?

A typical day involves reviewing physical therapy documentation and treatment plans submitted by providers to determine if they meet established medical necessity criteria. You may spend most of your workday analyzing patient records, applying evidence-based guidelines, documenting your recommendations, and collaborating virtually with providers, insurance representatives, and your clinical review team. Frequent video meetings and written communications are common as you clarify treatment justifications or support appeals. The role is fast-paced and detail-oriented, requiring strong organizational skills to manage multiple case files and deadlines efficiently. While remote, you remain an integral part of a clinical decision-making team, contributing directly to patient care quality and cost-effective service delivery.

What is a Remote Physical Therapy Utilization Review job?

A Remote Physical Therapy Utilization Review job involves evaluating physical therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review claims, provide recommendations, and collaborate with healthcare providers and insurance companies. The goal is to ensure appropriate care while preventing unnecessary treatments or costs. This position typically requires a background in physical therapy, strong analytical skills, and knowledge of insurance policies and medical guidelines.

More about Remote Physical Therapy Utilization Review jobs
What cities are hiring for Remote Physical Therapy Utilization Review jobs? Cities with the most Remote Physical Therapy Utilization Review job openings:
What states have the most Remote Physical Therapy Utilization Review jobs? States with the most job openings for Remote Physical Therapy Utilization Review jobs include:
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Remote Physical Therapy Utilization Review jobs near you
Infographic showing various Remote Physical Therapy Utilization Review job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Coordinator

Prosperous Health

Los Angeles, CA • Remote

Full-time

Medical, PTO

Posted 2 days ago

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