Texas Licensed Utilization Review LVN
Job Summary
A company is looking for a Utilization Review Specialist (LVN) Remote.
Key Responsibilities
- Conduct medical reviews and benefit verifications to determine medical necessity for healthcare services
- Serve as a liaison for medical and surgical procedure requests, ensuring timely communication with providers
- Complete denial letters in compliance with regulatory requirements and support quality assurance initiatives
Required Qualifications
- Licensed Vocational Nurse
- Active Texas RN license or multistate compact RN license
- 5+ years of utilization review experience in a healthcare setting
- Knowledge of HMO, PPO, and POS insurance
COMPLETE JOB DESCRIPTION
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