What are the responsibilities and job description for the Utilization Review Nurse (RN Compact – Concurrent Review) position at A-Line Staffing?
***Must hold RN Compact Licensure***
Job Title: Remote Utilization Review Nurse (RN Compact – Concurrent Review)
Pay Rate: $42.00 per hour
Job Type: (W2) 6-Month Assignment, may be potential to extend/convert based on business needs
Schedule: Tuesday – Saturday, 11:00 AM – 8:00 PM Central Time (Rotating holiday coverage required)
Location: Remote (Must hold an active Compact RN License)
Job Overview
This fully remote opportunity is ideal for an experienced Utilization Review Nurse who is comfortable working independently in a fast-paced environment. In this role, you’ll handle concurrent review activities, denial processing, and provider/member correspondence while ensuring compliance with healthcare regulations and internal policies.
You’ll be trusted to manage your own workflow, meet productivity targets, and maintain accuracy without direct in-office supervision—making strong time management and attention to detail essential for success.
Key Responsibilities
- Generate, process, and maintain provider and member correspondence for preservice and concurrent review
- Review and manage denial letters, including escalations and compliance deadlines
- Utilize denial management systems for claims processing, correspondence tracking, and appeals workflows
- Monitor internal communications, payer updates, and policy changes that impact review processes
- Ensure all work meets regulatory and compliance standards
- Maintain productivity expectations, progressing to 2.6 denial letters per hour once fully trained
Qualifications
- Active Registered Nurse (RN) license with Compact Licensure (required)
- Prior experience in Utilization Management (UM)
- Strong background in denials review and appeals processing
- Solid understanding of medical terminology
- Ability to work independently in a remote environment with minimal supervision
- Strong organizational, analytical, and communication skills
Work Environment & Expectations
- Fully remote position with structured schedule (Tuesday–Saturday)
- Rotating holiday coverage required
- Performance-driven role with clear productivity benchmarks
- Initial ramp-up period with lower volume expectations before reaching full productivity
INDSV
Pay: $42.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Application Question(s):
- Please provide your RN License number for verification purposes:
Experience:
- Utilization Management (UM): 2 years (Required)
Work Location: Remote
Salary : $42