Remote Utilization Review Nurse Auditor

Paycom - ATS; Mount Laurel Township (NJ); Remote; USD 85,000 - 120,000; Full time

Benefits offered by this job

Medical benefits

Vision benefits

Dental benefits

Paid time off

401k

Job summary

ExamWorks seeks a Utilization Review Nurse Auditor to perform quality reviews ensuring medical necessity and adherence to guidelines. The role requires an active RN/LPN/LVN license and coding certification, with 3–5 years of direct patient care experience. This is a 100% remote position with EST hours, Monday–Friday.

You will document findings, support compliance, and collaborate with providers while maintaining turnaround times and regulatory standards.

Qualifications

• Active nursing license required.
• * Current coding certification in specified coding systems.
• Minimum 3–5 years of direct professional patient care.

Responsibilities

• Perform quality utilization review and determine medical necessity.
• Work with providers to identify level, intensity and duration of care.
• Ensure reviews meet URAC and federal/state guidelines.

Skills

Nursing license

Coding certification

Medical terminology

Documentation accuracy

MS Office

Education

Accredited nursing program

Bachelor’s degree preferred

Tools

OASIS RAC-CT CCS CPC RHIT RHIA

Microsoft Office

Job description

ExamWorks seeks a Utilization Review Nurse Auditor to perform quality reviews ensuring medical necessity and adherence to guidelines. The role requires an active RN/LPN/LVN license and coding certification, with 3–5 years of direct patient care experience. This is a 100% remote position with EST hours, Monday–Friday.

You will document findings, support compliance, and collaborate with providers while maintaining turnaround times and regulatory standards.