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Utilization Review Coordinator Remote Jobs (NOW HIRING)

Gateway Rehab

Utilization Review Liaison - REMOTE

... care by coordinating authorizations, conducting utilization reviews, and collaborating with ... This position is fully remote and offers the opportunity to make a meaningful impact on patient ...

Sentara Healthcare

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site +1

Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... care coordination for determining efficiency, effectiveness, and quality of medical/surgical ...

Devoted Health

Utilization Management Coordinator

$21.70 - $27/hr

This is a full-time, remote position working five 8-hour days per week. Shifts are scheduled ... Review member inpatient status and clinical documentation to support episode updates * Ensure ...

Corrohealth

Coordinator, Utilization Management

This is a REMOTE position within US only. About this position: Title: Coordinator, Utilization ... Review timely filing guidelines regarding the utilization management process. * Track and follow up ...

CorroHealth

Coordinator, Utilization Management

This is a REMOTE position within US only. About this position: Title: Coordinator, Utilization ... Review timely filing guidelines regarding the utilization management process. * Track and follow up ...

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

As of Sep 10, 2026, the average hourly pay for utilization review coordinator remote in the United States is $29.61, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $34.62 per hour, depending on experience, location, and employer.

What does a utilization review coordinator do when working remotely?

A Utilization Review Coordinator working remotely is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and procedures. They review medical records, treatment plans, and insurance policies to ensure compliance with regulations and that patients receive proper care without unnecessary costs. Remote UR Coordinators collaborate with healthcare providers, payers, and patients primarily through electronic records and virtual communication, maintaining strong organizational and analytical skills. Their goal is to optimize patient outcomes while managing healthcare resources effectively.

How does a utilization review coordinator typically collaborate with healthcare providers and insurance companies?

As a remote Utilization Review Coordinator, you will regularly communicate with healthcare providers and insurance representatives via phone, email, and secure digital platforms. Your main responsibilities include reviewing patient records, making coverage determinations, and ensuring compliance with regulatory guidelines. Collaboration often involves clarifying medical necessity, gathering additional documentation, and participating in virtual team meetings to discuss complex cases. Strong communication skills and comfort with digital tools are essential for seamless coordination across remote teams.

What are the key skills and qualifications needed to thrive as a utilization review coordinator remote?

To thrive as a Utilization Review Coordinator Remote, you need a strong background in healthcare, knowledge of medical terminology, and often an active RN or LPN license. Familiarity with utilization management software, electronic health records (EHRs), and coding systems like ICD-10 and CPT is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating medical necessity and collaborating with providers. These skills ensure accurate, efficient case reviews and compliance with regulations, which are vital for optimizing patient care and managing healthcare costs.
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Utilization Review Coordinator Remote jobs near you
Infographic showing various Utilization Review Coordinator Remote job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

Utilization Review Coordinator

Lake Worth, FL • Remote

NRG MGMT LLC
See more jobs at NRG MGMT LLCexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago

Job description

Remedial Pro is a specialized medical billing company serving substance abuse treatment and behavioral health providers. Through services including benefits verification, billing and claims submission, and utilization review, we help treatment centers optimize revenue cycle management while focusing on delivering exceptional patient care. Our team is committed to accuracy, professionalism, efficiency, and outstanding client service

JOB DESCRIPTION

The primary goal is to monitor adherence to the facility’s utilization review plan to ensure the effective and efficient use of facility services and monitor the appropriateness of facility  admissions and extended facility stays.

Job Classification: Non Exempt Hourly        Reports To: Senior RCM Director

Supervisory Responsibilities:   None.

JOB DUTIES:

  • Completes Initial, concurrent, peer reviews, and expedited appeals in a timely manner to ensure continuous coverage.
  • responsible for all aspects of the authorization of treatment via insurance and managed care companies.
  • Utilize clinical information and knowledge of Medical Necessity criteria to effectively communicate plans of care to insurance case managers, facility staff, and healthcare partners.
  • Collaborate with facilities in order to obtain necessary clinical documentation for reviews and ensure appropriate lengths of stay and effective utilization of resources.
  • Represents the company in a positive manner per the Professional Standards of Conduct
  • Protects the confidentiality of patients and the privacy of staff
  • provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner.
  • Uses a computer to type correspondence, reports and other items as requested,
  • Experience in the Mental Health/Addiction space, May be a fully licensed SUDC, CAC,LADC, LCSW, CMHC or RN
  • Additional duties as assigned.

MINIMUM QUALIFICATIONS

  • Bachelor’s or Master’s degree in Behavioral/Mental Health Field (or related experience) preferred
  • A minimum of 3-5 years experience doing utilization review is required preferred
  • Expertise in psychiatric and addiction disorders
  • Experience interacting effectively with co-workers as well as clients.
  • Experience maintaining confidentiality in accordance with HIPAA and company policy requirements.

Required Skills/Abilities:

  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Proficient with Microsoft Office Suite or related software.
PHYSICAL REQUIREMENTS
  • Prolonged periods sitting at a desk and working on a computer.

Remote Position

Benefits:

• Competitive salary

• Health, dental, and vision insurance

• 401(k) with company match

• Paid time off and holidays

• Continuing education and professional development opportunities

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