Clearwater, FL · Remote
$16 - $21.50/hr
The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign ... Strong utilization of medical terminology and anatomy. * Assists Manager/Director with mentoring ...
Clearwater, FL · Remote
$16 - $21.50/hr
The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign ... Strong utilization of medical terminology and anatomy. * Assists Manager/Director with mentoring ...
Tampa, FL · On-site +1
$75K - $100K/yr
... record reviews to identify the emotional, social, and environmental factors affecting recovery ... understanding and utilization of available support. * Assist with discharge planning by ...
Tampa, FL · On-site +1
$75K - $100K/yr
... record reviews to identify the emotional, social, and environmental factors affecting recovery ... understanding and utilization of available support. * Assist with discharge planning by ...
Tampa, FL · On-site +1
$75K - $100K/yr
... record reviews to identify the emotional, social, and environmental factors affecting recovery ... understanding and utilization of available support. * Assist with discharge planning by ...
Tampa, FL · On-site +1
$75K - $100K/yr
... record reviews to identify the emotional, social, and environmental factors affecting recovery ... understanding and utilization of available support. * Assist with discharge planning by ...
Tampa, FL · Remote
$68K - $89K/yr
*Please Note: This is remote position but based out of Tampa, FL *The Senior Employee Benefits ... Evaluate claims experience, utilization trends, and financial performance to identify risks ...
Tampa, FL · Remote
$68K - $89K/yr
*Please Note: This is remote position but based out of Tampa, FL *The Senior Employee Benefits ... Evaluate claims experience, utilization trends, and financial performance to identify risks ...
... utilization, benchmarked against the best in the industry. * Run a tight performance rhythm -- 1-on-1s, team reviews, and metrics that tell you where to coach next -- addressing gaps early and ...
Quick apply
... utilization, benchmarked against the best in the industry. * Run a tight performance rhythm -- 1-on-1s, team reviews, and metrics that tell you where to coach next -- addressing gaps early and ...
This position is eligible for remote work, but regular business travel will be required, including ... Facilitate requirements sessions, data review meetings, and cross-functional workgroups to support ...
This position is eligible for remote work, but regular business travel will be required, including ... Facilitate requirements sessions, data review meetings, and cross-functional workgroups to support ...
This position is eligible for remote work, but regular business travel will be required, including ... Facilitate requirements sessions, data review meetings, and cross-functional workgroups to support ...
This position is eligible for remote work, but regular business travel will be required, including ... Facilitate requirements sessions, data review meetings, and cross-functional workgroups to support ...
Tampa, FL · Remote
Monitor utilization, fulfillment, quality, provider performance, encounter activity, and financial ... Establish governance processes, performance reviews, and operational monitoring routines. * Lead ...
Tampa, FL · Remote
Monitor utilization, fulfillment, quality, provider performance, encounter activity, and financial ... Establish governance processes, performance reviews, and operational monitoring routines. * Lead ...
Clearwater, FL · On-site +1
... remote opportunity! In this role, you will be serving as a subject matter expert for the design ... Provides senior-level oversight of day-to-day plan administration, including review of data ...
Clearwater, FL · On-site +1
... remote opportunity! In this role, you will be serving as a subject matter expert for the design ... Provides senior-level oversight of day-to-day plan administration, including review of data ...
... remote opportunity! In this role, you will be serving as a subject matter expert for the design ... Provides senior-level oversight of day-to-day plan administration, including review of data ...
Quick apply
... remote opportunity! In this role, you will be serving as a subject matter expert for the design ... Provides senior-level oversight of day-to-day plan administration, including review of data ...
Tampa, FL · On-site +1
$75K - $115K/yr
This is a full-time, permanent, remote position with benefits that will require occasional travel ... Lead proposal review meetings to ensure integration of all proposal activities * Lead proposal ...
Tampa, FL · On-site +1
$75K - $115K/yr
This is a full-time, permanent, remote position with benefits that will require occasional travel ... Lead proposal review meetings to ensure integration of all proposal activities * Lead proposal ...
Tampa, FL · On-site +1
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Monitors market and operational trends; analyzes, reviews, and formulates findings of member and ...
Tampa, FL · On-site +1
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Monitors market and operational trends; analyzes, reviews, and formulates findings of member and ...
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
Quick apply
... like remote patient monitoring and chronic care management in their pulmonary practices. With a ... Welcome patients into continuous care program(s) and review benefits and services included
Tampa, FL · On-site +1
$10K - $192K/yr
Review financial statements, management reporting packages, reconciliations, and other client ... Monitor engagement performance, resource utilization, and client satisfaction. * Identify ...
Tampa, FL · On-site +1
$10K - $192K/yr
Review financial statements, management reporting packages, reconciliations, and other client ... Monitor engagement performance, resource utilization, and client satisfaction. * Identify ...
Tampa, FL · On-site +1
$10K - $192K/yr
Review financial statements, management reporting packages, reconciliations, and other client ... Monitor engagement performance, resource utilization, and client satisfaction. * Identify ...
Tampa, FL · On-site +1
$10K - $192K/yr
Review financial statements, management reporting packages, reconciliations, and other client ... Monitor engagement performance, resource utilization, and client satisfaction. * Identify ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
Tampa, FL · Remote
$108K - $148K/yr
Identifies the need for new security technology solutions; designs, reviews and collaborates on the ... Additional Information Remote/WAH requirements: * WAH requirements: Must have the ability to ...
$19.06 - $22.91
2% of jobs
$22.91 - $26.76
9% of jobs
$29.40 is the 25th percentile. Wages below this are outliers.
$26.76 - $30.62
21% of jobs
The median wage is $33.74 / hr.
$30.62 - $34.47
23% of jobs
$34.47 - $38.33
13% of jobs
$41.32 is the 75th percentile. Wages above this are outliers.
$38.33 - $42.18
10% of jobs
$42.18 - $46.03
8% of jobs
$46.03 - $49.89
5% of jobs
$49.89 - $53.74
5% of jobs
$53.74 - $57.60
2% of jobs
$57.60 - $61.45
2% of jobs
$19
$37
$61
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.
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.
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.
The most popular types of Utilization Review jobs in New Port Richey, FL are:
For Remote Utilization Review jobs in New Port Richey, FL, the most frequently searched job titles are:
The top searched job categories for Remote Utilization Review jobs in New Port Richey, FL are:
Cities near New Port Richey, FL with the most Remote Utilization Review job openings:
Clearwater, FL • Remote
$16 - $21.50/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 6 hours ago
7.4
Based on 406 frontline employees who took The Breakroom Quiz
263rd of 898 rated healthcare providers
BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area.
Position Details:
The Medical Records Outpatient Coder III will work remotely on a full-time basis.
Sign on bonuses available!
Responsibilities:
Required Coding Experience:
Why BayCare?
Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve.
BayCare offers a competitive total reward package including:
Certifications and Licensures:
Education:
Experience:
Equal Opportunity Employer Veterans/Disabled
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance
10,000+ Employees
Pinellas Park, FL, US
1997
