Job Description

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.

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.