Horizon Healthcare Staffing
Description
RN / Nurse Reviewer
Temp to Hire
Monday - Friday 8:30am-5pm
Based in Nassau County, NY - NO TRAVEL
RN will be responsible for external appeal review for private sector clients.
This position is in an office environment in Nassau County
Responsibilities
- Responsible for daily review for external appeal contracts
- Assist physician reviewers to complete review activities and bring problems to the attention of the Assistant Director
- Assist with development of new review tools as products are developed.
- Screening and write up of external appeal review cases
- Follow up with patients, insurers, and providers relative to the external appeal process.
- Preparation of final report determinations for external appeals
- Track case to ensure timely response
Qualifications
Requirements:
- NYS RN License
- A minimum of 2 years acute care experience
- Excellent written and verbal communication skills
- Ability to meet short turnaround deadline for deliverables.
- Ability to work independently