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STI

Document Review Specialist

Richmond, VA · On-site

Document Review Specialist Location:Richmond, VA 23219 Duration: Long Term * Review and assess electronic documents against guidelines * Identify final documents requiring retention and ensure proper ...

Dane Street, LLC

Utilization Review Physician

Reviews span multiple case types, including preauthorization, appeals, DRG clinical validation, benefit review, and experimental/investigational determinations. Key Responsibilities * Perform ...

Larimer Law PLLC

Document Review Attorney

Mendon, NY · Remote

$28/hr

Larimer Law, PLLC, has offices in Rochester and Buffalo, New York, with a team of licensed attorneys who are trained and experienced in electronic document review, information governance and data ...

LCMC Health

Performs pre-certification, concurrent, discharge, retrospective, and appeal reviews, including peer reviews and eligibility verification when appropriate. * Applies standardized clinical criteria ...

Baltimore County

Senior Review Appraiser

Towson, MD

$66K - $75K/yr

Reviews complex appraisals and prepares complex appraisals in connection with Federal, State, and County projects for accuracy, standards, format, values and procedures. Makes recommendations of just ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

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Review information

What is the difference between Review vs Quality Assurance Specialist?

AspectReviewQuality Assurance Specialist
Primary RoleEvaluate and provide feedback on content, products, or servicesDevelop and implement testing processes to ensure product quality
Required SkillsAttention to detail, communication, analytical skillsTesting techniques, problem-solving, process improvement
Work EnvironmentOffice, remote, or client sitesOffice, lab, or production environments
CertificationsNot always required, but certifications like Content Review or Editing may helpQuality assurance certifications such as ASQ CQE or ISTQB

While both roles focus on quality, a Review primarily assesses content or products for accuracy and clarity, providing feedback for improvement. A Quality Assurance Specialist develops testing protocols and ensures products meet quality standards through systematic testing. Understanding these differences helps job seekers identify the right career path or job opportunity in quality-related fields.

What is a Review job?

A 'Review' job typically involves evaluating products, services, or content to provide feedback, ratings, and recommendations. People in review roles may write detailed reports, create video or written reviews, and help consumers or organizations make informed decisions. These jobs often require strong analytical skills, attention to detail, and clear communication abilities. Reviewers may work independently, as part of a media outlet, or for companies seeking quality assurance.

Can I get paid to review things?

Yes, as a reviewer, you can get paid to evaluate products, services, or content. Many companies hire freelance reviewers or work through platforms that connect reviewers with brands, often requiring good communication skills and honesty. Payment methods vary and may include per-review fees, hourly rates, or project-based compensation.

What are some common challenges faced by professionals in review roles and how can they be overcome?

Professionals in review roles often encounter challenges such as tight deadlines, handling large volumes of information, and maintaining objectivity and accuracy under pressure. To overcome these obstacles, it helps to develop strong organizational and time-management skills, utilize checklists or review protocols, and regularly communicate with team members to clarify expectations or address ambiguities. Leveraging technology and collaboration tools can also streamline workflows, ensuring that high-quality reviews are delivered efficiently.

How can I make 2000 a week working from home?

Review jobs, such as remote quality assurance or content moderation roles, can pay around $2000 weekly depending on experience, workload, and company. These positions often require strong attention to detail, relevant skills, and sometimes certifications, with flexible schedules allowing work from home. Earning this amount typically involves full-time hours or high-volume tasks.

What jobs pay $700 a day?

Jobs that can pay $700 a day include specialized roles such as freelance consultants, high-level contractors, certain medical professionals like anesthesiologists or surgeons, and skilled trades such as electricians or plumbers with experience. These positions often require advanced skills, certifications, or significant experience, and may involve freelance work, contract projects, or working in high-demand environments.

Can you actually become a Netflix movie reviewer?

Netflix does not typically hire individual reviewers; however, some media outlets or freelance critics review Netflix movies as part of their work. To become a professional reviewer, strong writing skills, industry knowledge, and experience with film critique are important, and some may work as freelancers or contribute to media outlets that cover streaming content.

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

To thrive as a Review Analyst, you need strong analytical abilities, attention to detail, and a background in data analysis or a related field. Familiarity with data management tools, spreadsheets, and review platforms such as Tableau or Microsoft Excel is often required. Critical thinking, effective communication, and the ability to work independently are standout soft skills for this role. These competencies ensure that data and content are accurately evaluated and actionable insights are delivered to support business decisions.
More about Review jobs
What cities are hiring for Review jobs? Cities with the most Review job openings:
What are the most commonly searched types of Review jobs? The most popular types of Review jobs are:
What states have the most Review jobs? States with the most job openings for Review jobs include:
Review jobs near you
Infographic showing various Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution.

Utilization Review

Discovery Institute of Addictive Disorders Inc.

Marlboro, NJ

Full-time

Posted 3 days ago

Job description

Position Summary

The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This position works closely with clinical staff, admissions, and insurance companies to ensure medical necessity documentation is accurate, authorizations are obtained timely, and reimbursement is maximized while maintaining compliance with payer requirements, Medicaid regulations, and accreditation standards.

Essential Duties and Responsibilities
  • Obtain initial and concurrent insurance authorizations for all levels of care.
  • Review clinical documentation to ensure it supports medical necessity.
  • Submit clinical information to insurance companies within required timeframes.
  • Monitor authorization expiration dates and request extensions before expiration.
  • Communicate authorization decisions and payer requirements to clinical staff.
  • Track approved days and notify leadership of denials or reductions in care.
  • Prepare and submit appeals for denied services when appropriate.
  • Maintain accurate authorization records in the electronic health record (EHR).
  • Work collaboratively with Admissions, Clinical, Nursing, and Billing departments.
  • Verify insurance benefits and coverage when necessary.
  • Monitor payer portals for authorization updates.
  • Assist with Medicaid and managed care authorization processes.
  • Participate in utilization review meetings and case conferences.
  • Generate reports on authorization status, denials, appeals, and payer trends.
  • Ensure compliance with Joint Commission, state, federal, and payer regulations.
  • Maintain confidentiality in accordance with HIPAA regulations.
  • Perform other duties as assigned.
Qualifications
  • High school diploma required; Associate's or Bachelor's degree preferred.
  • Minimum of two years of utilization review, case management, medical billing, or behavioral healthcare experience preferred.
  • Experience in substance use disorder or behavioral health treatment strongly preferred.
  • Knowledge of ASAM Criteria preferred.
  • Familiarity with Medicaid, commercial insurance, and managed care plans.
  • Strong organizational and time management skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple cases in a fast-paced environment.
  • Proficient in Microsoft Office and electronic health record systems.
Knowledge, Skills, and Abilities
  • Understanding of insurance authorization processes.
  • Knowledge of medical necessity criteria and documentation standards.
  • Strong analytical and critical thinking skills.
  • Excellent customer service and professional communication.
  • Ability to work independently while collaborating with interdisciplinary teams.
  • Attention to detail and accuracy.
  • Ability to maintain confidentiality.
Performance Expectations
  • Maintain timely insurance authorizations with minimal lapses.
  • Reduce avoidable authorization denials.
  • Ensure documentation meets payer standards.
  • Maintain accurate records and reporting.
  • Demonstrate professionalism, teamwork, and excellent customer service.
  • Comply with all organizational policies, HIPAA, Joint Commission standards, and applicable federal and New Jersey regulations.