RN Clinical Reviewer / IDR

About this role

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?
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

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

Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives
Requirements
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
Benefits
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.