RN Clinical Reviewer / IDR - Remote to Office-Based Setting

RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25309) • Location: Hybrid (Remote to Office-Based) - Jericho, NY • Employment Type: Full-time • reputed company reputed company: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the reputed company will be increased to $60/hr About reputed company: reputed company is a leading reputed company recruitment agency dedicated to connecting reputed company with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty reputed company, and private practices to match talented individuals with roles that reputed company with their skills and career goals. Position reputed company: reputed company is seeking an reputed company Registered reputed company Clinical Reviewer (IDR) to join a Non-profit organization located in reputed company. This hybrid role combines remote work with office-based responsibilities, focusing on conducting comprehensive medical-reputed company reviews and appeals for a respected non-profit organization. Why Join Us? • Work Schedule: Full-time, Hybrid (Remote to Office-Based) • reputed company reputed company: reputed company valuable experience in medical-reputed company review and dispute reputed company • Impactful Work: Contribute to fair reputed company processes in reputed company 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. • reputed company as a resource for the administrative and clinical staff in training, problem-solving, and clarifying determinations. Will reputed company technical assistance and conduct/participate in staff huddles. • Participate in reputed company training • Other activities as may be deemed necessary reputed company - Empowering reputed company, Enriching Lives Requirements Qualifications: • Education: Baccalaureate degree in Nursing or a graduate of an approved RN program. • Licensure: reputed company reputed company State RN license • Experience: • * Must have at least 3 years of experience in a Med-reputed company 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 reputed company and problem-solving skills Benefits • Competitive Compensation: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the reputed company will be increased to $60/hr. • Comprehensive Benefits: • * reputed company Vacation (after 6 months of employment) • 6 Major reputed company Holidays per year (after 6 months of employment) • 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 • 401(k) 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. Remote About reputed company: reputed company Apply tot his job Apply To this Job