New York Utilization Review Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
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
Keywords: VirtualVocations, Santa Ana , New York Utilization Review Nurse, Healthcare , Vista, California
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