Advanced Health is Currently Hiring REMOTE Utilization Review Specialists $18.54 - $25.11/HR

Advanced Health is searching for collaborative, innovative people committed to a shared community vision for health to join their team! Advanced Health is currently hiring REMOTE Utilization Review Specialists. As a Utilization Review Specialist, you would be responsible to review and apply guideline criteria to all referral and preauthorization requests that require a medical necessity determination. Responsibilities include reviewing submitted records to ensure criteria are met relating to medical necessity, and proper documentation while completing a variety of assignments to prepare assigned cases that do not meet medical necessity guidelines for medical appropriateness of procedure, service, or treatment for review with the Physician Reviewer for a decision.

Qualification/ Requirements:

• High school diploma or GED equivalent; associate’s or certification in medical assisting, administration, or other relevant areas strongly preferred

• Two to three years of experience using medical terminology, including ICD-9, and CPT coding required

• Knowledge of OHP or similar covered benefits required

• Two years of experience with a similar population in health plan care management or managed care coordination

• Experience administering the OHP and Medicare benefits and one to two years in utilization review preferred

This position is a FULL TIME, NON Exempt position. The schedule is Monday- Friday 8 am- 5 pm PST. For this position you MUST reside in OR, WA, CA, NV, AZ, CO, TX, WY, GA, AL, FL.

If you are interested in applying for this position and want to know more about the Company, Job Details, Requirements, and more, I have included the application link that will take you directly to Advance Health’s official website below! Also, don't forget to stop by our " Weekly Remote Job Listing'' page to find out what remote open positions are available NOW!

Advanced Health- Remote Utilization Review Specialist | Managed Care | Remote | Full Time | * OR, WA, CA, NV, AZ, TX, WY, GA, AL, FL, States Only $18.54- $25.11/HR

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