Job Opportunity Details

Job ID Specialty Geographic Location City State Recruiter
2358439 Legal Nurse Consultant New York, NY New York, NY NY Greenlife Healthcare Staffing

Company Name: Greenlife Healthcare Staffing
Recruiter Name: Jenille Harris
Contact Phone: 800-608-4025

Job Title: Legal Nurse Consultant (RN)

In HouseID:
Job #10972
Recruiter Email: hr@glhstaffing.com

Job Description

This is a Legal Nurse Consultant Opportunity Only!

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New York, NY    (Only QUALIFIED Healthcare Professionals accepted) Legal Nurse Consultant - Job #10972 - Legal Nurse Consultant (RN) - New York, NY

GENERAL RESPONSIBILITIES:

This individual will complete the full spectrum of activities related to State and Federal Independent Dispute Resolution (IDR) case determinations. They will conduct clinical level review, Prior Authorization, and disputed benefits review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process. You'll report directly to the Director|Assistant Director.

Compensation for the Legal Nurse Consultant (RN):

The salary for this position is $45 - $50 |hour

Benefits: Competitive and Negotiable

Schedule

Full-time
Monday to Friday (9 AM-5 PM)
Saturday or Sunday meeting (occasionally)
Contract Assignment

Requirements for Legal Nurse Consultant (RN):

Licensed as a Registered Professional Nurse in New York State
Legal Nurse Consultant Certification required
Minimum of 3 years experience in Med-Legal review setting
Knowledge and experience with electronic medical records
Ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff
Excellent written and verbal skills and has an ability to work independently with little supervision
Ability and desire to be flexible, innovative, and creative
Ability to meet deadlines in a time-sensitive environment

DUTIES:

1. 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.

2. 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.

3. Participate in collaborative training.

4. Other activities may be deemed necessary.




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