Utilization Review Specialist

TEKsystems • Los Angeles, CA

1d • Hybrid

About The Position

Regal needs 4 experienced RNs or LVNs to address a backlog in claims retro review. This role emphasizes the need for candidates with managed care authorization knowledge, detail-orientation, and strong communication skills. Regal is looking to quickly onboard candidates, potentially for permanent roles, to improve team efficiency and address upcoming regulatory changes. Candidates will prep medical records for medical directors and provide recommendations based on clinical review.

Requirements

• Active LVN or RN license
• UM experience
• Managed care authorization knowledge
• Detail-orientation
• Strong communication skills
• Familiarity with inpatient/outpatient claims
• Familiarity with productivity

Nice To Haves

• EZCap experience
• Coding (CPC cert)
• Experience with 'ez cap' software

Responsibilities

• Prep medical records for medical directors
• Provide recommendations based on clinical review
• Address a backlog in claims retro review

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed