Remote Utilization Review Nurse Auditor

ExamWorks; Mount Laurel Township (NJ); Remote; USD 75,000 - 100,000; Full time

Benefits offered by this job

Competitive benefits

401k

Paid time off

Job summary

ExamWorks is seeking a Utilization Review Nurse Auditor to join our team. This role performs quality utilization reviews and approves medically necessary care according to guidelines, ensuring reports are accurate and compliant.

The position is 100% remote with hours Monday–Friday, 8:00am–5:00pm EST. You will collaborate with providers, document findings, and help maintain regulatory standards including URAC and ERISA requirements.

Qualifications

• Active RN/LPN/LVN license required.
• 3–5 years direct patient care experience.
• Experience in utilization management; familiarity with URAC/regulatory standards.

Responsibilities

• Perform quality utilization reviews and document findings.
• Collaborate with providers to determine level, intensity and duration of care.
• Ensure reviews meet client, federal and URAC/state guidelines.
• Maintain UR records in the designated database.
• Direct Customer Service to ensure timely determinations.
• Adhere to turnaround times and company policies.

Skills

RN/LPN/LVN license

Patient care experience

Utilization management

Medical terminology

40 WPM typing

Education

High school diploma or equivalent

Graduate of accredited nursing program

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

ExamWorks is seeking a Utilization Review Nurse Auditor to join our team. This role performs quality utilization reviews and approves medically necessary care according to guidelines, ensuring reports are accurate and compliant.

The position is 100% remote with hours Monday–Friday, 8:00am–5:00pm EST. You will collaborate with providers, document findings, and help maintain regulatory standards including URAC and ERISA requirements.