Physician reviewer jobs in Levittown, New YorkCreate job alerts

Job Description Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria, • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision, • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes, • Provides copies of any criteria utilized in a review with the report in a timely manner, • Returns cases on or before the due date and time, • Makes telephone calls as mandated by the state and/or client specifics, • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job, • Attends all required orientation and training, • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits, • Board certification required, active practice required PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. Benefits • Robust opportunity for supplemental income, • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability, • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions., • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise, • Expanded credentials as an expert in Independent Medical Exams and physician advisor services, • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery. Apply for this job

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.

Job Description As a Clinical Reviewer, you will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. You 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. Duties include but are not limited to: • Conduct utilization reviews up to and including the appeal level. This includes chart screen, 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., • Knowledge and experience with electronic medical records including utilization, quality, and clinical charting., • 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. EDUCATION & EXPERIENCE: • New York State, Licensed Registered Nurse, required., • A bachelor’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. 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, or any other category protected under applicable law.

Job Description RN Clinical Reviewer (Proofer) - Jericho, NY (#25289) • Location: Jericho, NY, • Employment Type: Full-time, Temp-to-Hire, • Hourly Rate: $45/hr 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 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? • 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. 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. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives Requirements 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., • 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.

Job Description RN Clinical Reviewer (Proofer) - Jericho, NY (#25289) • Location: Jericho, NY, • Employment Type: Full-time, Temp-to-Hire, • Hourly Rate: $45/hr 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 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. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives