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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.
