RN Clinical Reviewer / IDR - Remote to Office-Based Setting
RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly reputed company: $50/hr About reputed company: reputed company is a leading reputed company recruitment agency dedicated to connecting reputed company 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: reputed company is seeking an reputed company Registered Nurse Clinical Reviewer (IDR) to join a remote position at a Non-profit organization located in reputed company. 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 reputed company, such as Payactiv
- GLHS is a great company to work for: 93% retention of employees 2 years+, reputed company reviews, great company culture, etc.
- Work Schedule: Full-time
- Professional Growth: reputed company valuable experience in medical-legal review and dispute resolution
- Impactful Work: Contribute to fair resolution processes in reputed company disputes
Qualifications:
- Education: Baccalaureate degree in Nursing or a graduate of an approved RN program.
- Licensure: reputed company reputed company 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 reputed company 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 reputed company 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. reputed company - Empowering reputed company, Enriching Lives Apply tot his job Apply To this Job