Remote Utilization Review Nurse Auditor

Paycom - ATS; Mount Laurel Township, Northern (NJ, KY); Hybrid; USD 45,000 - 63,000; Full time

Benefits offered by this job

Medical, vision, dental

401k

Paid time off

Job summary

ExamWorks is seeking a Utilization Review Nurse Auditor to perform quality utilization reviews and authorize medically necessary care. The role is fully remote with standard EST hours, requiring an active nursing license and coding certification.

You will work with providers to assess level and duration of care, document findings, and ensure compliance with URAC and client requirements. The position emphasizes accuracy, turnaround-time adherence, and ongoing professional education within a team

Qualifications

• Active unencumbered RN/LPN/LVN license required.
• 3–5 years of direct patient care experience preferred.
• Current coding certification: OASIS, RAC-CT, CCS, CPC, RHIT or RHIA.

Responsibilities

• Perform quality utilization review and determine medical necessity.
• Document findings and ensure timely, accurate reports.
• Coordinate with providers on care level, intensity, and duration.
• Maintain databases and ensure URAC/regulatory compliance.
• Respond to client inquiries and assist with quality assurance.

Skills

Medical terminology

Anatomy & physiology

Documentation accuracy

Time management

Independent worker

Education

RN license

BSN preferred

Tools

Microsoft Office

EHR software

Job description

ExamWorks is seeking a Utilization Review Nurse Auditor to perform quality utilization reviews and authorize medically necessary care. The role is fully remote with standard EST hours, requiring an active nursing license and coding certification.

You will work with providers to assess level and duration of care, document findings, and ensure compliance with URAC and client requirements. The position emphasizes accuracy, turnaround-time adherence, and ongoing professional education within a team