Remote RN: Utilization Review & Denials Specialist

Banner Health; Phoenix (AZ); Hybrid; USD 53,000 - 89,000; Full time

Benefits offered by this job

Remote work

12-week one-on-one preceptorship

Job summary

Banner Health is seeking a fully remote RN in the Utilization Review Department to impact patient care across our health system. You will review clinical information, conduct audits of billings, and collaborate with providers on medical decisions from home.

Requires 5+ years of acute bedside nursing, RN licensure in the practicing state, and strong critical thinking. The role offers autonomy, daily metrics, and a structured 12-week preceptorship to support success.

Qualifications

• Requires Registered Nurse licensure in the state of practice.
• Minimum five years of clinical nursing or related experience.
• Experience with evaluation techniques and billing processes is required.
• Strong written and verbal communication skills are essential.

Responsibilities

• Evaluates and intervenes for level of care and payor issues.
• Works with payor teams on denial management and appeals.
• Documents denial causes and resolutions for management review.
• Provides education and acts as a knowledge resource for staff.

Skills

Clinical nursing

Payer criteria knowledge

Critical thinking

Autonomous decision making

Education

RN licensure in practicing state

BSN preferred

Job description

Banner Health is seeking a fully remote RN in the Utilization Review Department to impact patient care across our health system. You will review clinical information, conduct audits of billings, and collaborate with providers on medical decisions from home.

Requires 5+ years of acute bedside nursing, RN licensure in the practicing state, and strong critical thinking. The role offers autonomy, daily metrics, and a structured 12-week preceptorship to support success.