RN Clinical Reviewer / IDR
Greenlife Healthcare StaffingPosted 1 weeks ago
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RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. 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? 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 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 Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives 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 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.