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Remote Psychiatric Utilization Review Jobs in Oregon

HealthEdge

UM RN - Behavioral Health

Review, research and authorize requests for authorization of elective, direct, ancillary, urgent ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...

CCS Fundraising

Director, Staffing

Remote; however, this role requires working Eastern Time business hours. REPORTS TO: SVP, Head of ... Partner with Business Systems to align staffing data with project tracking, utilization metrics ...

Bcbsa

Director, Trade Client Relations

OR · On-site +1

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

Blueprint Test Prep

Content Lead, PMHNP

OR · On-site +1

$125K/yr

Lead the creation, review, and maintenance of learning materials, including digital, print, and ... Minimum 5 years of clinical experience in psychiatric-mental health, or related fields * Experience ...

Valera Health

Mental Health Therapist

Baker City, OR · Remote

You'll practice at the absolute top of your license in a collaborative dream team of psychiatrists ... Work Your Way: Master your own schedule and enjoy the freedom of remote work with steady ...

SOLV Energy

Senior SCADA Engineer, EPC (Remote)

Bend, OR · On-site +1

$110K - $151K/yr

Mentor junior and mid-level engineers through technical review, knowledge sharing, and standards ... Effective utilization of project management, scheduling, and task management tools. Minimum Skills ...

Abbott

Distribution Field Manager - West

Portland, OR · Remote

$86K - $173K/yr

... utilization in current accounts. Understands and assesses customer's business issues and objectives ... This is a remote sales opportunity and will cover the West Region (AZ/NV/CA/ID/OR/WA) estimated 70 ...

Abbott

Distribution Field Manager - West

Portland, OR · Remote

$86K - $173K/yr

... utilization in current accounts. Understands and assesses customer's business issues and objectives ... This is a remote sales opportunity and will cover the West Region (AZ/NV/CA/ID/OR/WA) estimated 70 ...

AMSURG

Manager, Supply Chain

Manager, Supply Chain Remote Company Overview: AMSURG is an independent leader in ambulatory ... Produce monthly vendor utilization reports for each corporate contract by center * Perform various ...

Industrial Electric Manufacturing

Supply Planning Manager

OR · On-site +1

$129K - $166K/yr

Lead the supply review process within the monthly S&OP cycle, presenting supply constraints, risks ... Develop and monitor key supply planning KPIs including schedule attainment, capacity utilization ...

Upstart

DevOps Engineer, Cloud Platform

OR · On-site +1

$52.75 - $72.25/hr

Contribute to cost efficiency initiatives by optimizing resource utilization across Kubernetes and ... Remote Travel requirements As a digital first company, the majority of your work can be ...

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Remote Psychiatric Utilization Review information

What are some common challenges faced by professionals in remote psychiatric utilization review roles, and how can they be addressed?

Professionals in Remote Psychiatric Utilization Review often encounter challenges such as interpreting clinical documentation remotely, ensuring timely case reviews, and maintaining effective communication with providers and insurance companies. Staying organized and developing strong time-management skills are key to managing caseloads efficiently. Regularly participating in team meetings and leveraging secure digital communication tools can help bridge the gap between remote team members and facilitate collaboration. Continuous education on evolving mental health regulations and payer guidelines is also essential to remain effective in the role.

What is a remote psychiatric utilization review?

A Remote Psychiatric Utilization Review position involves evaluating mental health treatment plans and services to ensure they are medically necessary and meet insurance or regulatory guidelines. Professionals in this role typically review clinical documentation, assess the appropriateness of care, and make recommendations regarding the coverage of psychiatric services, all while working remotely. They collaborate with healthcare providers, insurance companies, and sometimes patients, to facilitate quality care and manage costs. Strong knowledge of mental health diagnoses, treatment protocols, and insurance policies is essential for success in this position.

What is the difference between Remote Psychiatric Utilization Review vs Remote Mental Health Case Manager?

AspectRemote Psychiatric Utilization ReviewRemote Mental Health Case Manager
CredentialsLicensed Psychiatrist, Psychologist, or Certified Utilization Review ProfessionalLicensed Clinical Social Worker, Mental Health Counselor, or Case Management Certification
Work EnvironmentReviewing medical records, insurance documentation, and making utilization decisions remotelyCoordinating care, assessing client needs, and providing support remotely
Employer & Industry UsageInsurance companies, health plans, and utilization review organizationsHealthcare providers, community agencies, and insurance companies

Remote Psychiatric Utilization Review focuses on evaluating medical necessity for psychiatric services, often within insurance and healthcare organizations. In contrast, Remote Mental Health Case Managers actively coordinate and support patient care. Both roles require mental health credentials but differ in daily tasks and focus areas.

What are the key skills and qualifications needed to thrive as a remote psychiatric utilization review specialist?

To thrive as a Remote Psychiatric Utilization Review specialist, you need a clinical background in nursing, social work, or mental health counseling, typically with relevant licensure (such as RN, LCSW, or LPC) and experience in psychiatric care. Familiarity with utilization review platforms, electronic health records (EHRs), and managed care systems is essential, along with certifications like CCM (Certified Case Manager) being advantageous. Strong analytical thinking, attention to detail, and effective verbal and written communication skills are crucial for evaluating cases and coordinating with providers. These competencies ensure accurate assessments, compliance with regulations, and optimal patient outcomes while managing costs in a remote work environment.

What are the most commonly searched types of Psychiatric Utilization Review jobs in Oregon?

The most popular types of Psychiatric Utilization Review jobs in Oregon are:

What are popular job titles related to Remote Psychiatric Utilization Review jobs in Oregon?

For Remote Psychiatric Utilization Review jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Remote Psychiatric Utilization Review jobs in Oregon look for?

The top searched job categories for Remote Psychiatric Utilization Review jobs in Oregon are:

What cities in Oregon are hiring for Remote Psychiatric Utilization Review jobs?

Cities in Oregon with the most Remote Psychiatric Utilization Review job openings:

Remote Psychiatric Utilization Review jobs near you

Medical Billing Specialist (Remote - Oregon/Southern Washington)

KLAMATH BASIN BEHAVIORAL HEALTH

Klamath Falls, OR • Remote

$20 - $24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Klamath Basin Behavioral Health rating

8.8

Company rating: 8.8 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Title: Medical Billing Specialist (Remote - Oregon/Southern Washington)

Department: Finance

Schedule: Monday-Friday, 8:00 AM - 5:00 PM Remote: Oregon/Southern Washington

WHAT IS GREAT ABOUT THIS OPPORTUNITY

Vision: Sharing the power of mental wellbeing

Mission: Providing compassionate care throughout our community

Pay & Benefits

$20.00 - $24.00 DOE

KBBH pays up to 92% of insurance premiums for employees and their families.

Benefits Include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 403(b) Retirement Plan with 8% Employer Match
  • 15 Paid Vacation Days (increases with tenure)
  • Accrued Wellness Days
  • Life Insurance
  • Disability Insurance
  • Flexible Spending Account (FSA)
  • Health Savings Account (HSA)
  • Employee Assistance Program (EAP)
  • Wellness Program
  • Employee Discounts
  • Tuition Reimbursement Program
  • Employee Scholarship Program
  • Certified Student Loan Forgiveness Work Location

Help ensure clients can access care by making the billing process accurate, efficient, and seamless.

We are seeking a detail-oriented Medical Billing Specialist who takes ownership of results and delivers exceptional service. In this role, you'll support both our clients and our organization by ensuring claims are processed accurately, reimbursements are collected promptly, and accounts are managed professionally and compliantly.

Success is measured through achievement of established productivity, quality, accuracy, compliance, and customer service standards while contributing to a respectful, collaborative workplace.

Remote Work Requirements

This position is approved for remote work within Oregon and Southern Washington.

Employees must maintain:

  • A dedicated, private workspace that supports confidentiality and HIPAA compliance.
  • Reliable high-speed internet capable of supporting video conferencing and cloud-based systems.
  • Professional availability during established business hours.
  • The ability to participate in virtual meetings, training, and collaboration activities using agency-provided technology.
  • Residency within Oregon or the designated Southern Washington service area.

Travel Requirement: Occasional travel to Klamath Falls, Oregon may be required for onboarding, training, department meetings, and other business needs.

What Success Looks Like

In this role, you will:

  • Submit accurate, timely claims for commercial insurance, Medicaid, Medicare, and client-pay accounts.
  • Resolve denied, unpaid, and underpaid claims to maximize reimbursement.
  • Maintain clean accounts receivable and proactively reduce aging balances.
  • Provide responsive, professional support to clients regarding billing and account questions.
  • Consistently meet productivity, quality, compliance, and customer service expectations.
  • Partner effectively with internal teams, payers, and external stakeholders to improve outcomes and processes.

Key Responsibilities

Billing, Claims & Reimbursement

  • Submit and manage billing for commercial insurance, Medicaid, Medicare, and direct-pay accounts.
  • Investigate and resolve denied, unpaid, and underpaid claims.
  • Process service authorizations and support timely reimbursement for approved services.
  • Manage follow-up, collections, and denial resolution activities while meeting established performance standards.

Accounts Receivable Management

  • Post payments, reconcile accounts, process refunds, prepare statements, and support month-end activity.
  • Monitor aging reports and perform collection activities in accordance with agency policies.
  • Communicate account status, reimbursement trends, and collection efforts as needed.

Client Billing Support

  • Process financial assistance applications and verify eligibility.
  • Respond to billing inquiries with professionalism, empathy, and accuracy.
  • Escalate complex account issues for additional review when necessary.

Compliance & Reporting

  • Maintain accurate billing, reimbursement, collections, and financial records.
  • Ensure compliance with federal, state, payer, and agency requirements.
  • Protect confidential client and organizational information in accordance with HIPAA and agency policies.

Team & Organizational Contribution

  • Participate in meetings, training, and professional development activities.
  • Stay current on billing regulations, reimbursement requirements, and industry changes.
  • Contribute to process improvement initiatives that enhance efficiency, service quality, and compliance.
  • Demonstrate professionalism, accountability, integrity, and respect in all interactions.

Preferred Qualifications

  • Two or more years of medical billing and coding experience, preferably in behavioral health, mental health, substance use disorder treatment, community mental health, or psychiatric services.
  • Working knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, authorizations, and payer reimbursement requirements.
  • Experience billing Oregon Medicaid behavioral health services and Medicare mental health services strongly preferred.
  • Knowledge of accounts receivable management, reimbursement practices, and collections.
  • Experience with electronic health record (EHR) systems and Microsoft Office applications.
  • Strong written and verbal communication skills.
  • Excellent organizational skills and attention to detail.
  • Ability to build and maintain effective relationships with clients, coworkers, insurance representatives, and external partners.

The Traits That Drive Success

  • Strong billing and reimbursement expertise
  • Problem-solving and analytical thinking
  • Client-focused service
  • Clear and professional communication
  • Accountability and ownership
  • Effective time management and organization
  • Accuracy, quality, and compliance focus
  • Collaborative, team-oriented mindset

Why Join Us?

We believe strong financial operations support exceptional client care. You'll join a team that values collaboration, respect, accountability, and continuous improvement while doing work that directly supports access to behavioral health services.

If you're a skilled billing professional who enjoys solving problems, improving outcomes, and delivering excellent service, we'd love to hear from you.

Other Considerations: Klamath Basin Behavioral Health celebrates diversity and is committed to creating inclusive and equal access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression, and veteran's status. or any other basis covered by appropriate law. Our employment decisions are based on qualifications, merit, and agency need.


Compensation details: 20-24 Hourly Wage


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