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Virtual Utilization Review Specialist at Ensemble - ApplyBlast

Virtual Utilization Review Specialist

Ensemble

2 months ago

4.0 on Glassdoor

Remote

Full Time

Medior

0 applicants

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About this role

The Virtual Utilization Review Specialist works remotely to assess medical necessity, resource utilization, and denial management for inpatient and observation admissions. The role involves reviewing clinical criteria, collaborating with physicians, financial clearance teams, and care managers, and ensuring compliance with quality and revenue integrity standards.

Responsibilities

Conduct medical necessity reviews for admissions
Identify and address over/under utilization of services
Coordinate denial appeals and manage revenue integrity

Skills

Qualifications

Bachelor's Degree in NursingRN licenseLPN licenseRN compact license

About Ensemble

ensemblehp.com

Headquarters

Cincinnati, Ohio, United States

Company Size

10001+ employees

Founded

2014

View Profile

Ensemble Health Partners is a revenue cycle management company that partners with hospitals, health systems and physician practices to optimize financial performance. They deliver end-to-end RCM services—patient access, coding and clinical documentation improvement, billing and collections, denials management and revenue integrity—backed by analytics and consulting. Ensemble combines operational teams and technology-enabled insights to accelerate cash flow, reduce write-offs, and improve patient financial engagement.