RN Clinical Reviewer / IDR - Remote to Office-Based Setting

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?

• 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

How to Apply: If you are ready to advance your career, we want to hear from you! Submit your Resume/CV to [email protected] or call our office at (800) 608-4025 to learn more about this opportunity. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives Apply tot his job Apply To this Job