Location: Albany, NY
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 currently seeking a Registered Nurse Clinical Reviewer to fill an opening with a Non-profit organization located in Albany, NY. This remote to office-based position involves conducting comprehensive medical-legal reviews, research, and appeals while ensuring regulatory compliance and producing accurate final determinations for a respected non-profit organization.
Why Join Us?
Work Schedule: Full-time, Remote to Office-Based position
Professional Growth: Gain valuable experience in medical-legal review and dispute resolution processes
Impactful Work: Contribute to fair and accurate resolution of healthcare disputes
Qualifications:
Education: Baccalaureate degree in Nursing or a graduate of an approved RN program
Licensure: Current New York State RN license
Experience: 3+ years in Med-Legal review setting; 1-3 years in acute care utilization review/appeals
Technical Skills: Experience with electronic medical records; strong research and documentation abilities
Soft Skills: Excellent written/verbal communication; ability to work independently and collaboratively; flexible, innovative, and creative; the ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff; meets deadlines in time-sensitive environments
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
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