Registered Nurse Clinical Reviewer – Remote to Office-Based | $50/hr | Medical-Legal Reviews

Job description

Registered Nurse Clinical Reviewer / IDR (#25302)
Location: Remote to Office-Based, New Hyde Park, NY 11040
Employment Type: Full-time
Hourly Rate: $50/hr

✅ Why Join Us?
✔️ Competitive Compensation: $50/hr
✔️ Comprehensive Benefits: Paid vacation (1–2 weeks), 6 major holidays, 5 sick days, health insurance eligibility, 401(k) matching, license reimbursement after 1 year
✔️ Great Work Culture: 93% employee retention over 2+ years, strong Google reviews, collaborative environment
✔️ Professional Growth: Gain experience in medical-legal review, dispute resolution, and IDR processes
✔️ Impactful Work: Ensure fair and accurate resolution of healthcare disputes

✅ Key Responsibilities
✔️ Conduct medical-legal reviews up to appeal level, including chart screening, regulatory research, insurer requirements, and final determinations
✔️ Serve as a resource for administrative and clinical staff, provide training, and assist with problem-solving
✔️ Participate in collaborative staff huddles and training sessions
✔️ Perform other duties as needed to support team and organizational goals

✅ Qualifications
✔️ Education: Baccalaureate degree in Nursing or approved RN program graduate
✔️ Licensure: Current New York State RN license
✔️ Experience: 3+ years in med-legal review; 1–3 years in acute care utilization review/appeals
✔️ Technical Skills: EMR proficiency, strong research, and documentation abilities
✔️ Soft Skills: Excellent written/verbal communication, independent and collaborative work, flexible, problem-solving, meets deadlines in time-sensitive environments