WCS Healthcare Partners is seeking a local contract nurse RN Clinic for a local contract nursing job in Queens, New York.
Immediate opening for a Clinical Review RN, this position is remote but must report into Flushing on occasion. Must have experience with Chart Review, MLT, Claims and Denials.
Job Function:
Excellent knowledge of all relevant PACE and applicable Federal and State regulatory requirements and guidelines, knowledge of CenterLight policies and procedures, and individual judgment and experience to assess the appropriateness of services, items provided, length of stay and level of care
Collects relevant medical information and applies the appropriate evidence-based guidelines and medical policy for denied services associated with appeal cases
Prepares cases for Medical Director Review or External Physician Advisor ensuring that all pertinent information
Job Requirements:
Disclosure: The hourly rates and/or salaries listed may or may not reflect total compensation packages including bonus and fringe benefits, etc., nor are the advertisement(s) posted a guarantee of a certain compensation package for a position or bona fide offer of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
ITN1
#LI-DNP
32730
White Cap Search Partners Job ID #32730. Posted job title: Local Contract - Rn - Clinical Review
With WCS Healthcare Partners, every Job Seeker grows stronger, moving one step forward with each job placement. We take the time to get to know the needs and qualifications of each Healthcare professional to match you with the right clinical setting, patient population, merging your compensation and career goals with your desired work environment. Our recruiters are experts at navigating the dynamic nature of healthcare employers to get your resume in front of the right decision makers.
NURSING
Registered Nurses (RN)
Licensed Practical Nurses (LPN)
Travel Nursing
Quality Assurance/Review, Performance Improvement, HEDIS
Nursing Leadership
Case Management
ALLIED HEALTH
Technologists: Medical, Laboratory, Cardiac, RadTech, X-Ray
Therapy: Physical, Occupational and Speech Therapy
Social Work: LCSW/LMSW, Case Management, Care Coordination
Med Support: Medical Assistants, Phlebotomy, Surgical/Sterile Techs
Pharmacists and Pharmacy Techs
Dental Hygienist, Dental Assistants
OPERATIONS & FINANCE
Practice Management
Clinical Operations
Administrative Support
Reception, Clerical, Call Center
Claims Appeals/Denials/Reimbursement
Insurance Pre-Authorizations
Medical Billing/Coding
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