Utilization Review Specialist

The Utilization Review Specialist is responsible for managing member utilization.
Determines member eligibility
Verifies the appropriateness of service levels
Manages the denial and appeal process
Manages Tr

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Utilization Review (RN)
Glen Allen, VA A-Line Staffing Solutions
Utilization Review Nurse I - Non-CA
Hampton, VA Centene
Account Balance Review Specialist
Richmond, VA HCA
Charge Review Specialist
Richmond, VA Virginia Commonwealth University Health Sy...
Registered Nurse (Required: Utilization Review...
Glen Allen, VA A-Line Staffing Solutions