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(Archived) Legal Nurse Consultant (RN)
Last Updated: 9/14/22
Job Description
JOB TITLE: 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
- Competitive and Negotiable
- 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
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.
Company Details
Brooklyn, New York, United States
Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
If you would like to learn more about other opportunities we offer, please call our office: (800) 608-4025 or submit your Resume/CV to us.