Registered Nurse Clinical Reviewer IDR

Albany, GA - USA

Monthly Salary: Not Disclosed

Posted on: 2 days ago

Vacancies: 1 Vacancy

Job Summary

Registered Nurse Clinical Reviewer / IDR - Remote to Office-BasedAlbany NY(#25305)

Location:Albany NY
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 currently seeking a Registered Nurse Clinical Reviewer to fill an opening with a Non-profit organization located in Albany NY. This remote to office-based position involves conducting comprehensive medical-legal reviews research and appeals while ensuring regulatory compliance and producing accurate final determinations for a respected non-profit organization.

Why Join Us

Competitive Compensation: Earn $50 per hour
Comprehensive Benefits:

1 Week of Paid Vacation based on accruals after 6 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment)
6 Major Paid Holidays per year after 6 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 Remote to Office-Based position
Professional Growth: Gain valuable experience in medical-legal review and dispute resolution processes
Impactful Work: Contribute to fair and accurate resolution of healthcare disputes

Qualifications:

Education: Baccalaureate degree in Nursing or a graduate of an approved RN program
Licensure: Current New York State RN license
Experience: 3 years in Med-Legal review setting; 1-3 years in acute care utilization review/appeals
Technical Skills: Experience with electronic medical records; strong research and documentation abilities
Soft Skills: Excellent written/verbal communication; ability to work independently and collaboratively; flexible innovative and creative;the ability to oversee problem solve and work collaboratively with peers medical analytical and administrative support staff; meets deadlines in time-sensitive environments

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 an experienced RN Clinical Reviewer with IDR expertise ready for a remote to Office-basedposition we want to hear from you! Submit your Resume/CV to or call our office at to learn more about this opportunity.

Greenlife Healthcare Staffing - Empowering Healthcare Professionals Enriching Lives

Required Experience:

Registered Nurse Clinical Reviewer / IDR - Remote to Office-BasedAlbany NY(#25305)Location:Albany NYEmployment Type: Full-timeHourly Rate: $50/hrAbout Greenlife Healthcare Staffing:Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professiona...