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Utilization Review Specialist
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Job Description
- Req#: 36D3B5B256
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $32.00 per hour
- Profit sharing and 401k matching for financial security
- Generous time off and opportunities for career growth
- Relaxed and upbeat work environment with a professional dress code
- Recognized as a Top Workplace in the healthcare industry for 2023
- Opportunity to work within a collaborative team dedicated to making a difference
What to Expect (Job Responsibilities):
- Initiate and maintain verbal and written communication with employers, clients, claimants, and medical providers
- Set up and manage files in relevant systems, assigning to nurses as necessary
- Facilitate and schedule appointments, keeping all parties informed of changes and updates
- Review medical records for completion and request additional records as needed
- Use evidence-based guidelines to determine medical necessity of treatment requests
What is Required (Qualifications):
- Certificate/diploma from a state-approved LPN/LVN program
- Current, active LPN/LVN license in one or more relevant states
- Minimum of 1 year of clinical experience
- Strong organizational and time-management skills
- Excellent oral and written communication skills
How to Stand Out (Preferred Qualifications):
- 3 to 5 years of clinical practice experience or 2 years of utilization review experience
- Multiple state licenses
- Experience with Workers' Compensation or disability claims
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