RN Clinical Reviewer (Proofer)
Jericho, New York•Full-time
$45+ hourly
$45+ hourly
About the Job
RN Clinical Reviewer – Jericho, NY
Location: Jericho, NY
Employment Type: Full-time
Pay: $45/hour
Employment Type: Full-time
Pay: $45/hour
Position Overview
We are seeking a meticulous Registered Nurse to join our clinical review team. In this role, you'll complete the full spectrum of activities related to Utilization and Quality reviews, applying your clinical expertise to conduct clinical-level reviews and support Medical Review Analysts and Physician Consultants in maintaining an accurate, high-integrity review process.
Why You'll Love Working Here:
- Competitive pay at $45/hour.
- Paid sick time.
- Health insurance.
- Additional benefits including Payactiv (earned wage access).
- Strong culture and retention — 93% of our team stays 2+ years.
- Full-time, Monday–Friday schedule.
- Meaningful work ensuring the accuracy and integrity of state-level healthcare dispute resolutions.
- A collaborative, innovative environment with room to grow your clinical review skills.
Qualifications:
- Bachelor's degree in Nursing, or graduate of an approved Registered Professional Nurse program, licensed to practice in New York State
- Active NY State RN license.
- Minimum 2 years in an acute care facility (preferably medicine/surgery or special care units) and/or 1–3 years in acute care utilization review.
- Experience with electronic medical records, including coding, quality, and clinical charting.
- Strong written and verbal communication; able to work independently and collaboratively; flexible and resourceful.
Key Responsibilities:
- Conduct utilization reviews up to and including the appeal level — chart screening, completing electronic worksheets, entering required information, and making level-one denial decisions when necessary.
- Conduct quality and clinical study data collection reviews, including chart review and detailed electronic data worksheets.
- Serve as a resource to administrative staff for training, problem-solving, and clarifying procedures; provide technical assistance and participate in staff huddles.
- Participate in collaborative training specific to clinical study objectives.
- Other duties as needed.