Job description

Medata, a company known for innovation and technology in the Risk Management Industry is seeking a UR Nurse to join our talented team. This seasoned UR Nurse may work from home from the following states: NV, TX, FL, GA and CA. We pride ourselves in experience, leadership and the commitment of offering solutions to meet today's needs and tomorrow's demands. If you are looking to work with a dedicated UR Team and want to work with the best in the industry, this position is for you.
Job Purpose:
Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines.
Duties:

• Perform Prospective, Concurrent and Retrospective level reviews
• Review medical records to determine the medical necessity of utilization review requests.
• Apply appropriate evidence-based treatment guidelines
• Obtain additional medical information from providers when applicable
• Provide notification of decisions to provider, requestor, claimant and carrier
• Able to explain utilization review decisions to provider, requestor, claimant and carrier when applicable

Requirements/Skills/Qualifications:

• Graduate of an accredited school
• Valid current RN license in good standing
• Able to perform the professional and technical skills of a Registered Nurse
• Minimum 2 years of direct patient care
• Excellent, written and oral communication skills
• Ability to read and interpret medical reports and treatment guidelines
• Must be able to maintain confidentiality
• Must possess strong personal organizational skills
• Must have experience and knowledge of intermediate computer skills
• Ability to work independently with little to no supervision
• Ability to work in a fast-paced and time-sensitive environment
• Ability to meet deadlines in a production driven environment
• Ability to work with WORD and EXCEL documents.

Preferences:

• Experience in Utilization Review, Workers Compensation is a plus
• Compact Nursing license is a plus
• Knowledge of evidence-based treatment guidelines is a plus
• Knowledge of medical coding of CPT and ICD10 codes is a plus

Job Type: Full-time

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