Greenlife Healthcare Staffing

RN Clinical Reviewer – IDR

Greenlife Healthcare Staffing

full-time

Posted on:

Location Type: Remote

Location: New York • United States

Visit company website

Explore more

✨ AI Apply
Apply

Salary

💰 $50 per hour

About the role

  • 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

Requirements

  • 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.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
Med-Legal reviewacute care utilization reviewelectronic medical recordsresearch capabilities
Soft Skills
written communicationverbal communicationindependent workflexibilityinnovationdeadline managementcollaborationproblem-solving
Certifications
Baccalaureate degree in NursingNew York State RN license