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Weekend Utilization Review Jobs in Florida (NOW HIRING)

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

ICBD

Utilization Review Manager

Lauderdale Lakes, FL

Utilization Review Manager Exact Billing Solutions Lauderdale Lakes, FL (Full-Time/ On-site) Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing ...

ICBD

Utilization Review Manager

Lauderdale Lakes, FL · On-site

Utilization Review Manager Exact Billing Solutions Lauderdale Lakes, FL (Full-Time/ On-site) Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing ...

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Weekend Utilization Review information

What is a Weekend Utilization Review job?

A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.

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

Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.

What does a typical weekend shift look like for a Utilization Review professional?

Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
More about Weekend Utilization Review jobs
What are the most commonly searched types of Utilization Review jobs in Florida? The most popular types of Utilization Review jobs in Florida are:
What are popular job titles related to Weekend Utilization Review jobs in Florida? For Weekend Utilization Review jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Weekend Utilization Review jobs in Florida look for? The top searched job categories for Weekend Utilization Review jobs in Florida are:
What cities in Florida are hiring for Weekend Utilization Review jobs? Cities in Florida with the most Weekend Utilization Review job openings:
Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Florida as of May 2026, with employment types broken down into 88% Full Time, and 12% Part Time. Highlights an 87% In-person, 3% Hybrid, and 10% Remote job distribution.

Utilization Review Specialist

Staffosaurus

Boynton Beach, FL • Hybrid

$65K - $80K/yr

Full-time

Medical, Dental, Vision

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Review Specialist

Boynton Beach, Florida, United States Or refer someone Job Openings Utilization Review Specialist

Utilization Review Specialist

Join Our Team:

As a Utilization Review Specialist, you will play a pivotal role in managing and performing various processes related to medical records requests, retrospective review requests, and chart appeals. If you are organized, efficient, and dedicated to maintaining the highest standards of quality in medical records management, we invite you to join us in our mission.

Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive health, dental, and vision insurance plans
  • Professional development opportunities
  • Supportive and positive work culture
  • Opportunities for career advancement

Utilization Review Specialist Requirements:

  • LMSW, LMHC, LPC, or other healthcare-related credentials or experience preferred.
  • Knowledge of behavioral health systems and various medical record platforms.
  • Two years of experience in a hospital or healthcare insurance setting required.
  • Bachelor's degree from an accredited college or university in social work, mental health, nursing, or a related degree required.

Utilization Review Specialist Responsibilities:

  • Manage and perform processes for medical records requests, retrospective review requests, and chart appeals.
  • Review medical records for any quality issues before submission.
  • Communicate with Supervisor and Quality Care team for assistance in meeting requests.
  • Prepare and distribute medical records to comply with payor requests, medical record reviews/requests, pre/post payment documentation requests, and chart appeals.
  • Prepare cover letters and chart appeal letters for medical necessity and claim denials.
  • Timely communicate outcomes, follow-up instructions, options, and related information to relevant administrative staff. Respond to all calls and emails within one business day unless otherwise required.
  • Document activity in Billing, UR software, and other approved locations.
  • Organize and file documents for ease of access in approved locations.
  • Communicate with Utilization Review team, Billing, Collections, and Verifications departments as needed for information relevant to medical records.
  • Assist in compiling information for data analysis.
  • Provide assistance in determining the likelihood of insurances covering treatment.
  • Maintain patient confidentiality in accordance with state and federal law.
  • Participate in internal information meetings, required in-service education and training, and company-wide performance improvement and compliance activities.
  • Perform other duties as assigned.

Pay: $65,000-$80,000 per year

Schedule: Hybrid M-F 9am-5pm

Location: Boynton Beach, Florida

Apply today! Or refer someone

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