Clinical Nurse Review Coordinator- New York licensed
Worker's Compensation and/or Utilization Management Required
This position is fully remote.
REQUIRED - active New York nursing license.
National Medical Reviews, Inc. (NMR) is looking for a licensed RN for a full-time salaried position Monday-Friday for medical record review.
National Medical Reviews, Inc. (NMR) is an URAC accredited Independent Review Organization. NMR’s mission is to provide high-quality, objective, independent and expedient medical review services.
The core business of NMR is providing independent medical reviews for all types of benefit disputes and quality of care issues in both the medical management and workers’ compensation settings. NMR provides expedient, unbiased, and expert opinions in a full range of utilization review services for both medical/surgical and behavioral health coverage addressing adverse determinations at the first, second and third level of review, as well as initial determinations.
These reviews include issues pertaining to medical necessity, experimental / investigational, administrative and quality of care concerns (for fraud, waste and abuse).
The role of the Nurse Review Coordinator (RC) is to coordinate the case review process. The RC will work with our administrative staff and panel of physician peer reviewers to answer the questions posed by our clients. The RC is responsible for the quality review of the physician's report. We need your clinical knowledge – do not worry about the process. We will teach you that!
This position is remote.
1 remote position available now.
Responsibilities:
• Collaborate telephonically and electronically with industry professionals (case managers, appeals coordinators, physician reviewers etc.)
• Summarize and produce well-written reports
• Interact with clients and resources throughout the United States
• Coordinate with non clinical administrative support staff to ensure quality and strict timelines are maintained
Requirements:
• Utilization Review / Utilization Management experience
• Broad clinical background
• Excellent written and verbal communication skills
• Computer proficiency using Microsoft Office (Word, Excel, Access)
• Highly organized
• Sharp attention to detail
Education & Background
• Current Registered Nurse (RN) license
• A minimum of five (5) years of clinical experience involving direct patient care
NMR provides a supportive, team-oriented work environment with an ongoing mentoring process. Training on medical records review and appeals procedures is provided.
This Company Describes Its Culture as:
• People-oriented -- supportive and fairness-focused
• Team-oriented -- cooperative and collaborative
Relocation Assistance Provided:
• No
Schedule:
• Flexible
This Job Is Ideal for Someone Who Is:
• Dependable -- more reliable than spontaneous
• Detail-oriented -- would rather focus on the details of work than the bigger picture
• High stress tolerance -- thrives in a high-pressure environment
Job Type: Full-time
Schedule:
• 40 hours per week
• Day shift
• Monday to Friday
License/Certification:
• RN license (Required)-Washington, DC
• BSN
Pay: $65,000.00 - $70,000.00 per year
Benefits:
• Employee assistance program
• Flexible schedule
• Life insurance
Work Location: Remote