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Remote Utilization Review Rn Jobs in Derby, KS (NOW HIRING)

Varsity Tutors

NCLEX Tutor

Wichita, KS · Remote

$40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

ITW

National Sales Manager

Wichita, KS · Remote

The role is a remote position; location base will be reviewed as this position covers all regions ... Enhance data utilization capabilities and enable stronger data led decision making in setting ...

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Remote Utilization Review Rn information

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$19

$38

$62

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

As of May 29, 2026, the average hourly pay for remote utilization review rn in Derby, KS is $38.60, according to ZipRecruiter salary data. Most workers in this role earn between $30.53 and $44.33 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Derby, KS? For Remote Utilization Review Rn jobs in Derby, KS, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Derby, KS look for? The top searched job categories for Remote Utilization Review Rn jobs in Derby, KS are:
What cities near Derby, KS are hiring for Remote Utilization Review Rn jobs? Cities near Derby, KS with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Patient Billing Representative

Five Star Solutions

Wichita, KS • On-site, Remote

$14/hr

Full-time

Posted 12 days ago

Job description

Join us as a Patient Billing Specialist, where you'll support patients with payment processing, billing education, insurance verification, and claims-related inquiries. This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies. Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.
This is a remote position for those that reside in = AL, GA, ID, IA, IN, KS, LA, MI, MS, NV, NC, ND, OH, OK, PA, SC, SD, TX, TN, UT, VA, WV, WI, WY
Qualifications
  • Customer service or call center experience required.
  • Healthcare billing, insurance, or claims experience strongly preferred.
  • Payment processing or financial transaction experience preferred.
  • High school diploma or GED required; additional billing or healthcare education a plus.
  • Technical proficiency with EMR systems and standard computer applications.
  • Ability to work independently in a remote or virtual environment.
  • Must be able to speak, read, write, and understand English.
  • Background check required in accordance with applicable laws.

Essential Functions
These functions emphasize patient advocacy, analytical billing expertise, regulatory awareness, and high-quality service delivery.
Patient Payment & Account Support
  • Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
  • Create, update, and maintain payment plans following established guidelines.
  • Ensure transaction accuracy, proper documentation, and data integrity.

Billing, Insurance & Claims Support
  • Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
  • Verify, audit, and update insurance information for completeness and accuracy.
  • Add or update insurance data within the EMR and resubmit pending or corrected claims.
  • Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
  • Identify discrepancies and coordinate with internal teams to resolve billing-related issues.

Problem Resolution & Patient Education
  • Research account history to determine the root cause of billing or payment concerns.
  • Recommend appropriate resolutions and next steps in alignment with Privia policies.
  • Maintain professionalism and empathy during complex or sensitive financial discussions.

Resource & System Utilization
  • Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
  • Navigate multiple systems simultaneously while assisting patients.
  • Adhere to all documentation, privacy, and security requirements.

Reliability & Continuous Learning
  • Maintain schedule adherence and consistent availability during assigned hours.
  • Complete all required Privia and client-mandated training.
  • Participate in ongoing uptraining and cross-training initiatives.

Ethical & Compliant Conduct
  • Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
  • Demonstrate professionalism, accountability, and patient-centered service in all interactions.

Requirements
  • Strong verbal and written communication skills.
  • Analytical problem-solving abilities and high attention to detail.
  • Solid understanding of healthcare billing and insurance concepts.
  • Ability to clearly explain complex billing information in patient-friendly language.
  • Comfort working across multiple systems and tools simultaneously.
  • Organized, self-motivated, and collaborative approach to work.

Pay and Benefits
Starting pay - $14/hr plus shift differential(extra $1/hr nights & wkds)
Working hours between - 7:00am-7:00pm (CST) ; Work Days - M-F
Paid Training - typically 2 weeks in length from 8:00am-5:00pm Mon-Fri (CST)
Status - Full Time 40 hours, Benefit eligible 1st of month after 60 days
$14 - $14 an hour
The above statements are intended to describe the general nature and level of work and are not intended to be an exhaustive list of all responsibilities, duties, and skills required of the job
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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