New York Utilization Review Nurse
A company is looking for a Utilization Review Registered Nurse (remote). Key Responsibilities Perform prior authorization reviews and make recommendations on workers' compensation compliance Analyze medical documentation to ensure appropriate utilization and adherence to treatment guidelines Identify and resolve discrepancies, denials, or disputed claims efficiently Qualifications Minimum 3 years of utilization review/prior authorization experience focused on workers' compensation Experience interpreting medical treatment guidelines Knowledge of prior authorization processes and regulatory compliance for workers' compensation cases Proficiency in electronic prior authorization processing platforms Ability to work independently and meet deadlines in a remote setting
A company is looking for a Utilization Review Registered Nurse (remote).
Key Responsibilities
Perform prior authorization reviews and make recommendations on workers' compensation compliance
Analyze medical documentation to ensure appropriate utilization and adherence to treatment guidelines
Identify and resolve discrepancies, denials, or disputed claims efficiently
Qualifications
Minimum 3 years of utilization review/prior authorization experience focused on workers' compensation
Experience interpreting medical treatment guidelines
Knowledge of prior authorization processes and regulatory compliance for workers' compensation cases
Proficiency in electronic prior authorization processing platforms
Ability to work independently and meet deadlines in a remote setting
