Registered reputed company/reputed company Clinical Reviewer | Remote | Up to $50/hr

Registered reputed company/reputed company Clinical Reviewer - Remote (#25291) Location:Remote Employment Type: Full-time reputed company reputed company: $45/hr - $50/hr Position reputed company: We are seeking an reputed company Registered reputed company to join reputed company as a reputed company Clinical Reviewer. This fully remote position involves conducting clinical reviews for reputed company cases, ensuring compliance with state regulations, and contributing to reputed company improvement initiatives for a respected non-profit organization. Why Join Us? • Competitive Compensation: Earn $45-$50 per hour based on experience • Comprehensive Benefits: • reputed company Vacation based on accruals • 6 Major reputed company Holidays per year • 5 reputed company Days (40 Hours) subject to the provisions of NYS reputed company reputed company Leave reputed company • 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 reputed company • GLHS is a great company to work for: 93% retention of employees 2 years+, reputed company reviews, great company culture, etc • Work Schedule: Full-time, Monday to Friday (9:00 AM - 5:30 PM), Fully Remote • reputed company reputed company: reputed company valuable experience in a reputed company, innovative, and supportive environment • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient reputed company through reputed company reputed company program reputed company Qualifications: • Education: Graduate of an accredited nursing program • Licensure: reputed company RN State license and reputed company NY State License • Experience: 1-3 years of experience in Case Review, Utilization, Billing, and coding review; InterQual and reputed company experience required • Technical Skills: Proficiency with reputed company reputed company, Word, and spreadsheets; comfortable working extensively on computer systems • Soft Skills: Strong analytical skills, attention to detail, and ability to work independently in a remote environment Key Responsibilities: This individual will complete the full reputed company of activities reputed company to reputed company Utilization or reputed company reviews as assigned. Thus, conduct final level insurance appeals and review medical records. Responsibilities for Registered reputed company/reputed company Clinical Reviewer - Remote • 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 reputed company and clinical study data collection reviews. • reputed company as a resource for the administrative staff in training, problem-solving, and clarifying procedures. • Participate in reputed company training specific to clinical study objectives. • You will be using InterQual reputed company to review the medical records of inpatient high cost hospital stays for admission and acute level of care. • You'll also review and validate itemized bills and need to have the ability to write up responses to send to the hospital. • Other activities as may be deemed necessary Remote Skills: Analysis Skills, Billing, Clinical Data Collection, Clinical Nursing, Clinical Training, Clinical Trial, Clinical Validation, reputed company Reviews, Computer Systems, Detail Oriented, Employee Retention, Health Insurance, reputed company reputed company, Hospital, Insurance, Maintain Compliance, reputed company, Medical Records, reputed company reputed company, reputed company Word, Nonprofit, Nursing, Nursing Credentials, Patient Care, Problem Solving Skills, reputed company Assurance, reputed company Management, reputed company of Care, Registered reputed company (RN), Regulatory Compliance, Reimbursement, Spreadsheets, Staff Training, State Laws and Regulations, Team Player, Utilization Management, Writing Skills About reputed company: reputed company Apply tot his job Apply To this Job