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Utilization Review Coordinator Remote Jobs in Florida

Utilization Review Nurse

Miami, FL ยท Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

UR COORDINATOR

Delray Beach, FL ยท On-site +1

$60K - $70K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of utilization review to ensure appropriate reimbursement by third party payers. This includes managing ...

RN Utilization Review

Southport, FL ยท On-site +1

$84K - $118K/yr

Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l ... Review admissions and service requests within assigned unit for prospective, concurrent and ...

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Utilization Review Coordinator Remote information

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.

What cities in Florida are hiring for Utilization Review Coordinator Remote jobs?

Cities in Florida with the most Utilization Review Coordinator Remote job openings:

Infographic showing various Utilization Review Coordinator Remote job openings in Florida as of August 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 34% In-person, and 66% Remote job distribution.

Utilization Review Specialist

Banyan Treatment Centers - Texas

Pompano Beach, FL โ€ข Remote

$45K - $65K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago


Job description

Utilization Review Specialist | Remote | Full-Time
$50,000 โ€“ $65,000 Annually | Weekdays (Weekend Availability as Needed)

Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50โ€“75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

About Banyan Treatment Centers

Banyan Treatment Centersย is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed byย TPG, one of the nationโ€™s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

Why Join Our Team?

  • Mission-driven work with real business impact โ€” your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization โ€” Joint Commissionโ€“accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility โ€” work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment โ€” partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow โ€” join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

Key Responsibilities

  • Manage a caseload of 50โ€“75 patients, authorizing 15โ€“25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) โ€” valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.