RN Clinical Reviewer
About The Position
Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a Non-profit organization located in New York. This hybrid role combines remote work with office-based responsibilities, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization. Why Join Us? Work Schedule: Full-time, Hybrid (Remote to Office-Based) Professional Growth: Gain valuable experience in medical-legal review and dispute resolution Impactful Work: Contribute to fair resolution processes in healthcare disputes
Requirements
- Education: Baccalaureate degree in Nursing or a graduate of an approved RN program.
- Licensure: Current New York State RN license
- Experience: Must have at least 3 years of experience in a Med-Legal review setting. Must have 1-3 years of experience in acute care utilization review/ appeals background.
- Technical Skills: Experience with electronic medical records; strong research capabilities
- Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills
Responsibilities
- Conduct reviews up to and including the appeal level. This includes chart screen, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
- Act as a resource for the administrative and clinical staff in training, problem-solving, and clarifying determinations.
- Will provide technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training
- Other activities as may be deemed necessary
Benefits
- Competitive Compensation: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the rate will be increased to $60/hr.
- Comprehensive Benefits: Paid Vacation (after 6 months of employment)
- 6 Major Paid Holidays per year (after 6 months of employment)
- 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act
- License Reimbursement after 1 year of employment
- Health insurance is subject to plan eligibility requirements
- 401(k) Matching eligibility after 1 year of employment
- Benefits from Paychex, such as Payactiv
- GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
11-50 employees
