Utilization Review Specialist (RN/Chiro) – In-Office

Enlyte; Wayne (PA); Presencial; USD 53 000 - 76 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical

Dental

Vision

401(k)

Tuition Reimbursement

Resumo da oferta

Enlyte is seeking an in-office Utilization Reviewer in Wayne, PA. The role requires PA RN or Chiropractor license with at least 2 years of clinical experience. You will review workers’ compensation treatment referrals for medical necessity and collaborate with providers and claims staff to ensure appropriate care.

The position is Monday–Friday, 9 AM–5 PM EST, with base pay ranging from $52,750 to $76,000 annually. Benefits include health, dental, vision, 401(k), and tuition reimbursement.

Qualificações

• Bachelor's degree required.
• RN or LVN with valid state license.
• 2+ years clinical experience or advanced degree with experience.
• Strong knowledge of medical terminology and guidelines.

Responsabilidades

• Perform utilization review for workers’ comp-related referrals.
• Assess and ensure medical treatment plans are appropriate.
• Collaborate with providers, claims adjusters, and stakeholders.
• Evaluate medical documentation for standards and regulations.
• Prepare clear written reports and verbal summaries.
• Stay current on industry regulations and best practices.
• Participate in team meetings to improve processes.

Conhecimentos

Analytical thinking

Critical thinking

Communication skills

Interpersonal skills

Detail oriented

Independent and collaborative

Software familiarity

Formação académica

Bachelor's degree

RN or LVN license (state)

Ferramentas

Healthcare software

Descrição da oferta de emprego

Enlyte is seeking an in-office Utilization Reviewer in Wayne, PA. The role requires PA RN or Chiropractor license with at least 2 years of clinical experience. You will review workers’ compensation treatment referrals for medical necessity and collaborate with providers and claims staff to ensure appropriate care.

The position is Monday–Friday, 9 AM–5 PM EST, with base pay ranging from $52,750 to $76,000 annually. Benefits include health, dental, vision, 401(k), and tuition reimbursement.