Remote Utilization Review Nurse 30231
Company: Solving IT
Location: Atlanta
Posted on: June 27, 2025
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Job Description:
One of the largest health insurers in the nation is focused on
continuously building an industry-defining, world-class IT
capability. Healthcare is forever evolving, especially due to
emerging technologies, making this a great experience to add to
your resume. Come join their winning team! This contract role as a
Remote Utilization Review Nurse will involve working in the
insurance or managed care industry using medically accepted
criteria to validate the medical necessity and appropriateness of
the treatment plan. Pay Rate: $38 - $41 per hour Responsibilities:
• Performing accurate and timely medical review of claims suspended
for medical necessity, contract interpretation and pricing. •
Initiating and/or responding to correspondence from providers or
members concerning medical determinations. Job Requirements: ? •
Knowledge of accreditation, i.e. URAC, NCQA standards and health
insurance legislation. • Awareness of claims processes and claims
processing systems. • PC proficiency to include Microsoft Word and
Excel and health insurance databases. • Verbal and written
communication skills with ability to communicate to physicians,
members and providers and compose and explain document findings. •
Organizational skills and prioritization skills. • Registered Nurse
(RN) with unrestricted license in state. • 3 years clinical
experience. Benefits : Solving IT, a Woman and LGBTQ owned and
operated organization is thrilled to provide a comprehensive
benefit package to all our W2 employees and their families,
regardless of gender. We are proud to offer five diverse health
plan options as well as a PPO dental plan through Blue Cross Blue
Shield, Term Life/AD&D Insurance, and a 401(k) Savings Plan.
Solving IT covers a portion of the health and dental premiums for
our employees. As you progress in your professional journey,
Solving IT is dedicated to accommodating your evolving preferences
and matching you with fulfilling projects. We champion equality and
embrace diversity in all its forms. Creating an atmosphere that
encourages varied perspectives to collaborate fosters personal
development, strengthens team unity, and contributes to the overall
success of the organization! Whether you're seeking your next
career challenge or aiming to stay abreast of industry trends,
Solving IT is committed to supporting your career advancement. We
actively encourage applications from all backgrounds and utilize
the most up-to-date market insights and compensation data to ensure
that you receive not just advice, but the complete Solving IT
Experience.
Keywords: Solving IT, East Point , Remote Utilization Review Nurse 30231, Healthcare , Atlanta, Georgia
