Utilization Review Nurse at Winston Staffing Utilization Review Nurse at Winston Staffing in Maplewood, New Jersey Posted in 3 days ago.
Type:
full-time
Job Description:
100% remote but would need to go to Newark, NJ first day to pick up equipment and orientation Review insurance claims
- Analyze medical records and documentation
- Compare cases with clinical guidelines and insurance policies
- Write appeal recommendations or determinations
- Work with providers, insurance companies, and case managers
- Ensure decisions follow regulatory and medical necessity standards