Utilization Review Specialist

Triage and manage intake coordination of medical treatment authorization requests. Reviews authorization requests for approval in accordance with evidence-based medical treatment guidelines. Research claim file in relation to the requested medical treatment and interpret medical reports while utilizing critical thinking, and applies appropriate established guidelines to requested treatment. Advocate for the injured worker and claims department, ensuring proposed treatment requests are appropriate for the diagnosis. Escalate treatment requests outside of authorization authority for UR Nurse review. Ensures that utilization review processes are performed in accordance with the time limits and other requirements set by state law and company policy. Routinely contacts providers to clarify treatment requests, examination findings, as well as obtain additional medical information as needed. Fosters a positive and close working relationship with other Company staff, including the claims staff, nurse case management, special investigations, legal, liens, the call center, and client services.

According to JobzMall, the average salary range for a Utilization Review Specialist in 3555 Farnam St, Omaha, NE 68131, USA is $37,000 to $53,000 per year.

Berkshire Hathaway, Inc. engages in the provision of property and casualty insurance and reinsurance, utilities and energy, freight rail transportation, finance, manufacturing, retailing, and services. It operates through following segments: GEICO, General Re, Berkshire Hathaway Reinsurance Group, Berkshire Hathaway Primary Group, Burlington Northern Santa Fe, LLC, Berkshire Hathaway Energy, McLane Company, Manufacturing, Service and Retailing, and Finance and Financial products.