What You’ll Do
- Review patient charts and documentation against defined coverage criteria
- Work with internal AI software that enables review productivity
- Apply structured processes to determine documentation sufficiency
- Identify missing or inconsistent documentation and flag appropriately
- Produce clear, standardized written summaries of review outcomes
- Meet daily throughput and quality targets (e.g., reviews/day, QA pass rates)
- Incorporate feedback from QA and continuously improve accuracy and speed
- Collaborate with product team to refine software over time
What You'll Bring: The Skills and Experience You’ll Leverage
Required:
- Active RN license (BSN preferred but not required)
- 2+ years of clinical experience OR prior utilization review / documentation review experience
- Extremely strong attention to detail
- Fast learning rate of new concepts
- Ability to follow structured workflows and apply rules consistently
- Comfort working in a high-throughput, metrics-driven environment
- Strong written communication skills
- DME, Medicare regulations/surgical dressing reviews preferred but not required
The Rewards & Reality: Compensation, Benefits & Logistics
- Meaningful Compensation: $70,000-$90,000 base salary
- Comprehensive Health & Wellness: We cover 100% of your health insurance premium and provide access to high-quality dental and vision insurance plans for you and your dependents.
- Plan for the Future: We offer a 401(k) plan to help you save for your future. At this time, the company does not offer a 401(k) match.
- Career Growth: You'll have opportunities for rapid career advancement in a company that's at a major inflection point. We want you to grow with us.