New Jersey Licensed Utilization Analyst
Company: VirtualVocations
Location: Topeka
Posted on: January 24, 2025
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Job Description:
A company is looking for an Associate Utilization Analyst to
review medical documentation for accurate clinical
determinations.
Key Responsibilities
Review professional medical claims policy issues and claims in
pending status
Make clinical determinations based on reviews and relevant
guidelines
Prepare cases for internal and external review and respond to
inquiries from Claim Policy teams
Required Qualifications, Training, and Education
High School Diploma or GED required; BSN preferred
Must have a NJ State Registered Nurse License or MD (non-board
certified accepted if certified abroad)
Preferred minimum of 3 years clinical experience
Preferred minimum of 3 years business/insurance experience
Preferred certification in medical coding
Keywords: VirtualVocations, Kansas City , New Jersey Licensed Utilization Analyst, Professions , Topeka, Kansas
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