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Remote Utilization Review Jobs in Jackson, MS (NOW HIRING)

Gaf

Regional Sales Director

Jackson, MS · Remote

This position is remote based and will be responsible for leading a team and customers within our ... Identify and justify the utilization of independent sales representatives within the region ...

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Jackson, MS

Remote Utilization Review information

See Jackson, MS salary details

$18

$36

$60

How much do remote utilization review jobs pay per hour?

As of Jul 17, 2026, the average hourly pay for remote utilization review in Jackson, MS is $36.85, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $42.31 per hour, depending on experience, location, and employer.

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

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

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 is a Remote Utilization Review job?

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

Patient Billing Representative

Five Star Solutions

Jackson, MS • Remote

$14/hr

Full-time

Posted 2 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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