Utilization Review Nurse - LVN

A company is looking for a Utilization Review Nurse-LVN/LPN. Key Responsibilities • Conduct first level reviews for outpatient and inpatient treatment requests to assess medical necessity • Process appeals for non-certification of services and ensure proper documentation • Collaborate with hospital staff for patient discharge and refer cases to appropriate programs as needed Required Qualifications • Current LVN license in the United States or U.S. territory • 1+ years of clinical experience required • Knowledge of medical claims and ICD-10, CPT, HCPCS coding • Proficiency in Microsoft Office applications • Ability to meet productivity and quality standards