Job Title: Non-Clinical RN
Experience: Open to various clinical backgrounds/experience. Must have 2+ years of clinical experience post graduation, must has critical thinking and problem solving skills.
***Must have BSN and NYS RN license***
Location: Onsite required; office in Lake Success/New Hyde Park, NY
Hours of Operation: M-F 7a-5:30p *flexible start between 7am-9am (40hrs/wk)
Start date: ASAP
Pay: $50-54/hr *DOE
Volume: Will do appeals work under the IDR team handling on average 10 cases a day. These will be a mix between simple and complex cases. They will be reviewing documentation, codes, and more for out of Network bills and cost and making determinations on how to move forward based on the evidence.
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.
DUTIES:
QUALIFICATIONS:
EDUCATION AND EXPERIENCE:
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