Remote Utilization Review Specialist

Ethos-Risk-Services; United States; On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

100% remote

US PT hours

Job summary

Ethos Risk Services in the United States is seeking a full-time Utilization Review Specialist (REMOTE) to process Utilization Management and Independent Review requests for clients. You will review case requests, collect documentation, and support Physician Advisors, delivering professional service by phone and email.

The role requires at least 1 year in a healthcare setting, HIPAA knowledge, and strong communication.

Qualifications

• High school diploma required.
• 1 year in a healthcare-related setting preferred.
• Knowledge of HIPAA regulations required or helpful.

Responsibilities

• Review and process Independent Review (IR) requests.
• Request and organize additional medical documentation for Physician Advisors.
• Schedule peer-to-peer calls as needed.
• Ensure all work meets Client, State, Federal, and URAC compliance standards.
• Maintain the security and confidentiality of PHI.
• Provide timely, professional client service via phone and email.
• Adhere to company policies and turnaround times.

Skills

Microsoft Office

Communication

Detail oriented

Phone etiquette

Education

High School Diploma

Job description

Ethos Risk Services in the United States is seeking a full-time Utilization Review Specialist (REMOTE) to process Utilization Management and Independent Review requests for clients. You will review case requests, collect documentation, and support Physician Advisors, delivering professional service by phone and email.

The role requires at least 1 year in a healthcare setting, HIPAA knowledge, and strong communication.