Registered Nurse (RN) Clinical Reviewer / IDR – Remote – New York, NY

Job description

Registered Nurse (RN) Clinical Reviewer / IDR – Remote – New York, NY 10001 (#25310C)

📍 Location: Remote (New York, NY 10001)

✅ Position Overview
We are seeking a Registered Nurse (RN) Clinical Reviewer / IDR to join a remote non-profit healthcare team based in New York. This role focuses on medical-legal chart reviews, appeals processing, and clinical determination support within utilization review and dispute resolution workflows.

✅ Why Join Us?
✔️ Competitive pay: $50/hour
✔️ Fully remote work opportunity
✔️ Full-time position
✔️ Paid vacation and sick time accrual
✔️ Paid holidays
✔️ Health insurance eligibility
✔️ 401(k) matching eligibility
✔️ License reimbursement opportunities
✔️ Strong organizational culture and long-term stability

✅ Qualifications
✔️ Keywords: Registered Nurse, RN Clinical Reviewer, Utilization Review, IDR Nurse, Appeals Nurse, Remote RN Jobs
✔️ Active New York State RN license required
✔️ Minimum 3 years in medical-legal review setting required
✔️ 1–3 years utilization review or appeals experience required
✔️ Bachelor’s degree in Nursing or approved RN program required
✔️ Strong EMR and clinical documentation skills
✔️ Excellent analytical, writing, and communication skills

✅ Key Responsibilities
✔️ Conduct medical chart reviews and appeal-level determinations
✔️ Research clinical guidelines, regulations, and insurer requirements
✔️ Prepare written clinical determinations and documentation
✔️ Support utilization review and dispute resolution processes
✔️ Collaborate with clinical and administrative teams
✔️ Provide clarification and support for clinical decisions
✔️ Maintain accurate and timely electronic documentation