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Job DescriptionRN Clinical Reviewer - Jericho, NY (#25314) Location: Jericho, NY Employment Type: Full-time Hourly Rate: $45/hr - $50/hr Position Overview:We are seeking a skilled Registered Nurse Clinical Reviewer to join a team at a respected non-profit organization in Jericho, NY. This role combines clinical expertise with analytical review, focusing on utilization reviews, quality data collection, and appeal-level determinations to support healthcare quality improvement initiatives. Why Join Us? • Competitive Compensation: Earn $45 - $50 per hour, based on experience., • Comprehensive Benefits:, • 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act., • 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., • Work Schedule: Full-time, Monday - Friday, • Professional Growth: Gain valuable experience in utilization review, quality improvement, and clinical data analysis., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through rigorous clinical review processesQualifications:, • Education: Baccalaureate degree in Nursing or graduate of approved Registered Professional Nurses training program., • Licensure: Active New York State RN license., • Experience:, • Must have a minimum of two years of experience in an acute care facility, preferably in medicine/surgery or special care units; and/or one to three years of experience in acute care utilization review., • Knowledge and experience with electronic medical records, including utilization, quality, and clinical charting., • Skills:, • Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent written and verbal skills., • Ability to work independently with little supervision., • Ability and desire to be flexible, innovative, and creative.Key Responsibilities:, • Conduct utilization reviews up to and including the appeal level. This includes chart screens, complete electronic worksheets, enter required information and make level one denial decisions when necessary., • Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets., • Act as a resource for the administrative staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles., • Participate in collaborative training specific to clinical study objectives., • Other activities as may be deemed necessary.

Job DescriptionRN Clinical Reviewer (Proofer) - Jericho, NY (#25289) Location: Jericho, NY Employment Type: Full-time, Temp-to-Hire Hourly Rate: $45/hr Position Overview:We are seeking a meticulous Clinical Reviewer Proofer Registered Nurse who will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to conduct clinical-level review, supporting Medical Review Analysts and Physician Consultants to ensure an appropriate and accurate process. Why Join Us? • Competitive Compensation: Earn $45 per hour., • Comprehensive Benefits:, • Paid Sick Time, • Health insurance, • 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., • Work Schedule: Full-time (5 days per week), Temp-to-Hire position., • Professional Growth: Gain valuable experience in a collaborative, innovative, and supportive environment, enhancing skills in clinical review., • Impactful Work: Play a critical role in ensuring the accuracy and integrity of state-level healthcare dispute resolutions.Qualifications:, • Education: Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York., • Licensure: Must have an active NY State RN license., • Experience: Must have a minimum of 2 years experience in an acute care facility, preferably in medicine/surgery or special care units, and/or 1 to 3 years experience in acute care utilization review., • Technical Skills: Knowledge and experience with electronic medical records, including coding, quality, and clinical charting., • Soft Skills:, • Ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent written and verbal skills., • Ability to work independently with little supervision., • Ability and desire to be flexible, innovative, and creative. Key Responsibilities:This individual will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to conduct clinical-level review, supporting Medical Review Analysts and Physician Consultants to ensure an appropriate and accurate process. • Conduct utilization reviews up to and including the appeal level. This includes the chart screen, complete electronic worksheets, entering required information, and making level one denial decisions when necessary., • Conduct quality and clinical study data collection reviews. This includes a chart review, complete detailed electronic data worksheets., • Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles., • Participate in collaborative training specific to clinical study objectives., • Other activities as may be deemed necessary.

Job Description Registered Nurse Clinical Reviewer / IDR – Jericho, NY (#25154D) • Location: Jericho, NY, • Employment Type: Full-time, • Hourly Rate: $60/hr (based on experience) About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer / IDR to fill an opening with a Non-profit organization located in Jericho, New York. This role is ideal for an experienced RN with a utilization review or appeals background who thrives in a collaborative, independent, and deadline-driven environment. Why Join Us? • Competitive Compensation: Earn a competitive rate of $60 per hour based on experience., • Comprehensive Benefits:, • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment), • 6 Major Paid Holidays per year (after 3 months of employment), • 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, • 401(k) 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., • Work Schedule: Full-time position., • Professional Growth: Gain valuable experience in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through fair, evidence-based clinical determinations. Qualifications: • Education: Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program., • Licensure: Must be licensed as a Registered Professional Nurse in New York State., • Experience:, • 1–3 years of experience in utilization review and/or appeals background required., • Must have at least 3 years of experience in Med-Legal review setting., • Technical Skills: Knowledge and experience with electronic medical records (EMR)., • Soft Skills:, • Ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent written and verbal communication skills., • 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. Key Responsibilities: • Conduct reviews up to and including the appeal level. This includes chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations., • 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., • Participate in collaborative training., • Other activities as may be deemed necessary. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives

Job Description In the Clinical Reviewer RN (Proofer) role, you will review all NYS Dispute Resolution and External Review determinations for accuracy of decisions, mathematical determinations, content, grammar, punctuation and state required conventions. The Clinical Reviewer RN (Proofer) will utilize their clinical knowledge and editorial skills to produce a final, clean copy for each case determination. This individual will track errors and retrain clinical and administrative staff to mitigate production errors. This position is based in IPRO's Headquarter office located in Jericho, NY. QUALIFICATIONS: • Evidence of medical proofing, editing skills including professional writing and/or publishing., • Knowledge and experience with electronic medical records including coding, quality, and clinical charting., • Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent communication and verbal skills., • Ability to work independently with little supervision., • Ability and desire to be flexible, innovative, and creative., • Post graduate studies demonstrating proficiency in writing, editing and proofing skills EDUCATION & EXPERIENCE: • Licensed as a Registered Professional Nurse in New York State., • Bacholer's degree in Nursing OR graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York, required., • Two (2) year’s experience in an acute care facility required, preferably in medicine/surgery or special care units; AND/OR one to three year’s experience in acute care utilization review, required. The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The hourly range for this position is $36.0577 – $43.2692. Actual salary range and /or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, protected veteran status or military status, or any other category protected under applicable law.

Job Description Clinical Reviewer (RN) As a Clinical Reviewer, you will complete the full spectrum of activities related to Independent Dispute Resolution (IDR) case determinations. Conducting clinical level review, managing case staging and appeal processes within strict deadlines. Duties include but are not limited to: • Conduct reviews up to and including the appeal level. This includes documentation screening, writing case summaries, determining documentation adequacy, researching insurer requirements, complete decision templates and preparing final determinations., • Act as a resource for the administrative and clinical staff in training, problem solving, and clarifying determinations., • Training and mentoring new RNs as the project expands., • Participate in collaborative training. This is an in office position based in IPRO's headquarter office located in Jericho, NY QUALIFICATIONS: • 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., • 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. Education & Experience: • New York Licensed Registered Nurse, required., • A bachelor’s degree in nursing or graduate of an approved Registered Professional Nurses training program, required., • Minimum of two (2) years’ experience in a clinical setting required. The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The hourly rate for this position is $38.46- $43.27. Actual salary and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status.

Job DescriptionRegistered Nurse Clinical Reviewer / IDR - Jericho, NY (#25154D) Location: Jericho, NY. Employment Type: Full-time. Hourly Rate: $60/hr (based on experience). Position Overview: We are currently seeking a Registered Nurse Clinical Reviewer / IDR to fill an opening with a Non-profit organization located in Jericho, New York. This role is ideal for an experienced RN with a utilization review or appeals background who thrives in a collaborative, independent, and deadline-driven environment. Why Join Us? • Competitive Compensation: Earn a competitive rate of $60 per hour based on experience., • Comprehensive Benefits:, • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment)., • 6 Major Paid Holidays per year (after 3 months of employment)., • 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., • 401(k) 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., • Work Schedule: Full-time position., • Professional Growth: Gain valuable experience in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting., • Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through fair, evidence-based clinical determinations. Qualifications: • Education: Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program., • Licensure: Must be licensed as a Registered Professional Nurse in New York State., • Experience:, • 1-3 years of experience in utilization review and/or appeals background required., • Must have at least 3 years of experience in Med-Legal review setting., • Technical Skills: Knowledge and experience with electronic medical records (EMR)., • Soft Skills:, • Ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent written and verbal communication skills., • 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. Key Responsibilities: • Conduct reviews up to and including the appeal level. This includes chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations., • 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., • Participate in collaborative training., • Other activities as may be deemed necessary.

As the Clinical Reviewer, you will be responsible for the review and processing of all requests for Independent Reviews from External Agencies in accordance with contractual guidelines. Duties include but are not limited to: Performing case reviews utilizing regulatory guidelines criteria and clinic

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer to join a non-profit organization in Jericho, NY.This full-time position offers a competitive hourly rate of $60 based on experience.The successful candidate will have a bachelor's degree in nursing and be licensed in New

Job Description As a Coding Reviewer, you will be responsible for the general coding validation and verification and preparation of independent dispute resolution reviews from external state and federal agencies in accordance with reporting requirements. Duties include but are not limited to: • Confirm and verify submitted codes for DRG validation., • Apply national coding standards and regulations to the claims and clinical data., • Provide subject matter input and support agency-wide projects., • Other duties as assigned. This position requires working on-site at the Jericho, NY office. Qualifications: • Excellent interpersonal and communication skills, both written and verbal., • Ability to relate effectively with technical, medical, analytical and administrative personnel., • Proficiency in EHR applications, office technology, and Microsoft applications including Word, Excel, and PowerPoint., • Being able to handle sensitive and confidential information., • Ability to work in a team environment and independently. Education & Experience: • Licensed Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS)/ Certified Coding Specialist Physician (CCS-P) required., • Technical knowledge of coding and DRG validation with CPT, HCPCS experience and ICD-10 certification required, • Bachelor’s degree in healthcare administration or health information management preferred., • Minimum of two (2) years of experience abstracting and coding of outpatient medical records for billing., • Some experience in utilization reviews preferred. The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The annualized salary range for this position is $65,000.00 – $70,000.00. Actual salary range and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget. The salary range listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.

Key Responsibilities Adherence to established behavioral and administrative review guidelines and criteria Adherence to timelines, standards, and elements associated with organizational determinations and notifications Daily interactions with UM Support staff and providers to ensure clinical informa

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