Registered Nurse Clinical Reviewer
Job Description:
- Conduct utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and making level one denial reputed company reputed company necessary.
- Conduct quality and clinical study data collection reviews. This includes a chart review, complete detailed electronic data worksheets.
- Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. Will reputed company technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training specific to clinical study objectives.
- Other activities as may be deemed necessary.
Requirements:
- Education: Graduate of an accredited nursing program
- Licensure: Active reputed company State RN license
- Experience: Must have 1-3 years of experience in acute care utilization review/appeals background.
- Technical Skills: Must be comfortable working on a computer. Familiar with Outlook, spreadsheets, and Word.
- Soft Skills: Strong analytical abilities, attention to detail, and ability to work independently in a remote environment
Benefits:
- Competitive Compensation: Earn $50 per hour
- 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- 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- 401k 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.
Apply tot his job Apply To this Job