RN Clinical Reviewer / IDR - Remote
Remote•United States•Full-time
$50+ hourly
$50+ hourly
About the Job
RN Clinical Reviewer / IDR - Remote (#25310C)
Location: Remote
Employment Type: Full-time
Hourly Rate: $50/hr
Employment Type: Full-time
Hourly Rate: $50/hr
Position Overview:
Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a remote position at a Non-profit organization located in New York. Responsibilities, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization.
Why Join Us?
- Competitive Compensation: $50/hr.
- Comprehensive Benefits:
- 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment).
- 6 Major Paid Holidays per year (after 3 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.
- Work Schedule: Full-time
- Professional Growth: Gain valuable experience in medical-legal review and dispute resolution.
- Impactful Work: Contribute to fair resolution processes in healthcare disputes.
Qualifications:
- 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.
Key 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.