RN Clinical Reviewer (New York) Job at ProKatchers LLC, New York, NY

RGZqbmhpQ2VaMHBISzY2YmFwS2ZsUDZF
  • ProKatchers LLC
  • New York, NY

Job Description

Job Title : RN Clinical Reviewer

Location : New York, NY 10004

Duration : 3+ Months / 13 Weeks

Education : Bachelors in Nursing (BA/BSN) required

Shift Details : 9:00 AM 5:00 PM / Hybrid Onsite & Remote

Specific Skills :

  • Review medical charts for accuracy, completeness, and proper diagnosis sequencing.
  • Validate clinical and coding assessments in alignment with regulations.
  • Conduct audits of high-risk claims and billing patterns to identify discrepancies and potential FWA.
  • Prepare detailed clinical review reports, including rationale, research, and corrective action recommendations.
  • Assist with documentation for audits, compliance reviews, recoupments, and regulatory inquiries.
  • Active New York State RN License (Primary Source Verified)
  • Minimum 2 years of clinical experience
  • 5+ years of Healthcare Experience required

General Description:

We are seeking an experienced Registered Nurse (RN) to perform detailed medical chart reviews to ensure accuracy, correct sequencing of diagnoses, and compliance with regulatory guidelines. The RN will review documentation from Consultation Reports, H&P, Operative Reports, Progress Notes, and Discharge Summaries, including complex cases.

Job Tags

Part time, Shift work,

Similar Jobs

Tropigas de Puerto Rico Inc

Automotive Mechanic Job at Tropigas de Puerto Rico Inc

Job Description Job Description Departamento : Taller Personas a cargo : n/a Posiciones Disponibles : Varias Localizaciones : Gurabo Sobre la posicin Estamos en bsqueda de Mecnicos" para trabajo a tiempo completo en nuestro taller en Gurabo con veh...

Sluhn

Security Officer - Night Shift Job at Sluhn

 ...Security Officer The Security Officer provides a valuable resource of information and service for patients, visitors and the staff at the hospital. At all times the officer must display a professional, helpful, and positive attitude when dealing with all internal and... 

MedMark Treatment Centers

Part-Time Nurse Practitioner/Physician Assistant Job at MedMark Treatment Centers

 ...Job Description Description Part Time Nurse Practitioner/Physician Assistant Opportunity Roswell, NM Schedule: 12 hours/week (flexible) during Monday - Friday 6:30 am to 1:00 pm MedMark Treatment Center is an innovative physician practice primarily... 

Oxford Solutions

WordPress Developer Job at Oxford Solutions

 ...ContractOxford Solutions is working with a client seeking a WordPress Developer. In this fully remote role, you'll be responsible for...  ...development.Qualifications: Bachelor's degree in Computer Science, Web Development, or a related field is preferred 2+ years of... 

SGS Consulting

Profee Coder (EPIC) Job at SGS Consulting

Job Responsibilities: Review medical records and clinical documentation to identify services provided by the physician Assign the correct CPT and ICD-10-CM codes for patient encounters, procedures, and diagnoses. Ensure that claims are accurate to facilitate prompt...