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Remote Utilization Review Jobs in Georgia (NOW HIRING)

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Build and present performance reviews and executive-ready reporting; drive corrective action plans ... Recommend technology improvements (automation, templates, dashboards, portal utilization) to ...

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Build and present performance reviews and executive-ready reporting; drive corrective action plans ... Recommend technology improvements (automation, templates, dashboards, portal utilization) to ...

$155K - $175K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

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

Market Physician Executive

Atlanta, GA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Review and approve APP, RN, SW, and PharmD plans of care. * Provide direct and indirect patient ... This position will be remote within the designated market with occasional in-home patient treatment ...

Electrical Engineering Department Head

Conyers, GA · On-site +1

$97K - $125K/yr

... Remote (Hybrid options available) About Raymond: We are a progressive, forward-thinking ... Monitor and manage departmental workload, utilization, staffing assignments, and resource planning.

Showing results 21-40

Remote Utilization Review information

See Georgia salary details

$18

$35

$58

How much do remote utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote utilization review in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

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

The most popular types of Utilization Review jobs in Georgia are:

What cities in Georgia are hiring for Remote Utilization Review jobs?

Cities in Georgia with the most Remote Utilization Review job openings:

Infographic showing various Remote Utilization Review job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 13% Part Time, 7% Contract, and 3% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

(Remote) Team Lead, Account Follow-Up Services

Harris

Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 26 days ago


Harris Computer rating

8.5

Company rating: 8.5 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

79th of 245 rated software companies


Job description

MEDHOST, a division of Harris; is seeking an Account Follow-Up Services Team Leader who will provide strategic oversight of Hospital Insurance Follow-Up Services, including multi-team performance, payer strategy, denial prevention initiatives, workforce planning, and operational scaling.


This role drives measurable improvement in A/R aging, collections performance, and denial overturn rates through KPI leadership, cross-functional collaboration, training programs, continuous process innovation and adjust priorities on the fly.


This remote role welcomes candidates anywhere in the US. Preference will be given to candidates who can work in CST timezone.


Salary:

60K - 70K


AI & Innovation Mindset

We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency. Candidates should be comfortable using AI enabled technologies, including copilots, chat based AI assistants, and automation tools, as part of their everyday work while maintaining appropriate judgment, security, and compliance standards.


What your impact will be:

Operational & Performance Leadership

  • Own performance across one or more Insurance Follow-Up teams (or multiple clients).
  • Set daily/weekly/monthly targets for productivity, quality, and collections, ensuring adherence to service-level expectations.
  • Lead KPI governance (Days in A/R, A/R > 90, denial rate, overturn rate, net collection rate, first-pass resolution, productivity per FTE, quality).
  • Build and present performance reviews and executive-ready reporting; drive corrective action plans.

Denials Strategy & Payer Optimization

  • Lead payer trend analysis and root-cause programs to reduce preventable denials (eligibility, auth, coding/modifiers, timely filing, medical necessity, COB).
  • Standardize best practices for appeals, reconsiderations, and payer escalations.
  • Partner with leadership on payer playbooks and escalation pathways; ensure consistent documentation standards.

Training, Enablement & Quality Control

  • Design and maintain scalable training programs, SOPs, and payer-specific job aids.
  • Establish QA frameworks and audit cadence; monitor error trends and implement remediation plans.
  • Develop team leads and high-potential staff through structured coaching and succession planning.

Innovation & Process Improvement

  • Drive workflow optimization through queue design, inventory management, and prioritization strategies.
  • Recommend technology improvements (automation, templates, dashboards, portal utilization) to increase output and reduce rework.
  • Lead change management and adoption for new tools, payer policy updates, and client requirements.

Cross-Functional & Client Partnership

  • Collaborate with coding, payment posting, charge entry, eligibility, and client stakeholders to resolve systemic issues impacting AR.
  • Participate in client performance calls and support recovery plans for at-risk KPIs.

What we are looking for:

  • 3-5+ years of RCM experience with deep Insurance Follow-Up/Denials expertise.
  • 2-4+ years leading teams (supervisor/team lead/manager level).
  • Demonstrated success improving KPI outcomes (A/R aging reduction, denial reductions, increased overturn rate, improved collections).
  • Strong analytics/reporting capability (Excel required; dashboard/reporting tools preferred).
  • Advanced knowledge of payer behavior, denial categories, escalation processes, and appeals best practices.
  • Ability to travel when required to client site.
  • High Speed Internet access (minimum 300 Mbps download speed) and unlimited data.
  • Smart phone for Multi Factor Authentication (MFA) application.
  • Excellent communication skills (verbal & written), good judgement, tact, initiative, and resourcefulness.
  • Must be detail oriented, organized, and ability to multi-task.
  • Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
  • Must be flexible with a "can do" attitude and have the ability to remain professional under high pressure situations.

What we can offer:

  • 3 weeks' vacation and 5 personal days
  • Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
  • Employee stock ownership and RRSP/401k matching programs
  • Lifestyle rewards
  • Remote work and more!

About MEDHOST:

MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms. Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.


About Harris:

Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses.


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About Harris Computer Systems

Sourced by ZipRecruiter

Harris Computer Systems, based in Ottawa, ON, CA, is an established player in the field of public sector software technology. Since its inception in 1976, the company has been striving to make clients' operations more efficient through reliable, practical, and flexible software solutions. Its extensive portfolio primarily serves utility, healthcare, public sector, and educational institutions, contributing to the betterment of public services through technology. Harris strongly believes in the value of forward-thinking technology and the power it has to drive progress for the public sector. This methodology is entirely in line with their mission to ensure customer success by providing reliable, practical, and robust software solutions.

Industry

Accounting services

Company size

1,001 - 5,000 Employees

Headquarters location

Ottawa, ON, CA

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