Greenlife Healthcare Staffing
11 - 50 employees
Greenlife Healthcare Staffing is a New York based healthcare recruitment agency specializing in permanent hires and locum tenens. We match physicians and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
Registered Nurse – Medicaid Clinical Reviewer
Job not on LinkedIn
🕒 May 5
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Greenlife Healthcare Staffing
11 - 50 employees
Greenlife Healthcare Staffing is a New York based healthcare recruitment agency specializing in permanent hires and locum tenens. We match physicians and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
📋 Description
• 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 decisions when necessary. • Conduct quality and clinical study data collection reviews. • Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. • Participate in collaborative training specific to clinical study objectives. • You will be using InterQual criteria 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
🎯 Requirements
• Education: Graduate of an accredited nursing program • Licensure: Active RN State license and active NY State License • Experience: 1-3 years of experience in Case Review, Utilization, Billing, and coding review; InterQual and Milliman experience required. Must have at least 2 years of Med/Surg experience. • Technical Skills: Proficiency with Microsoft Outlook, 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
🏖️ Benefits
• Competitive Compensation: Earn $45-$50 per hour based on experience • Comprehensive Benefits: • - 1 Week Paid Vacation based on accruals • - 6 Major Paid Holidays per year • - 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act • - 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 Paychex, such as Payactiv • - GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc
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