Utilization Review SpecialistVirtualVocations • Santa Clara, California, United States
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Utilization Review Specialist
VirtualVocations • Santa Clara, California, United States
30+ days ago
Job type
- Full-time
Job description
A company is looking for a Utilization Review Specialist.
Key Responsibilities
Review and process Independent Review (IR) requests for potential conflicts of interest
Request and organize additional medical documentation for Physician Advisors
Ensure all work meets Client, State, Federal, and URAC compliance standards
Qualifications
High school diploma or equivalent required
Minimum of 1 year in a healthcare-related setting required
Knowledge of HIPAA rules and regulations required
Prior experience in utilization review, medical management, or insurance preferred
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Utilization Review Specialist • Santa Clara, California, United States
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