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Registered Nurse - Medical Records Investigator, NY, NY  

Registered Nurse - Medical Records Investigator, NY, NY

Tired of the backaches, long hours and stressful shifts? Use your brain and not your back, uncovering unnecessary treatment and waste in healthcare. If you are a seasoned bedside warrior with extensive Celebration400-181x400.jpgMedical Surgical experience and are looking to step away from bedside, and into a unique office setting in Manhattan, this is for you.

As a detective (cost outlier auditor), you'll work with hospitals and insurance companies to uncover the truth. Your solid medical-surgical nursing experience is the foundation of a successful detective. You'll be fully trained and provided all the tools needed to enrich your nursing career.

For nearly five decades, this forward-thinking organization has been a mainstay here in Manhattan as a leader in medical review. They have been leading the charge in providing health care assessment services that assist clients in improving the appropriateness, quality and cost-effectiveness of healthcare. This is a group with an outstanding reputation for delivering top-notch medical review programs for prospective, concurrent and retrospective monitoring, thus helping to eliminate the "waste" in healthcare. The external reputation is only surpassed by the incredible internal company culture. This is a place where many come to learn, grow and enjoy an entire happy career.

Why You Should be Interested:

· Looking to leave bedside and work in a professional, fun office environment.

· Be a part of a dynamic team of talented nurses who share a passion for investigating.

· Comprehensive training and tools and ongoing learning to help fuel your success.

· Ditch the 12-hour shifts/ weekends and holidays and join us Monday-Friday

· Comprehensive Health Care Benefits

· TransitCheck

· Great PTO Plan

· Retirement Savings Plan

· Fun company events and regular employee recognition.

The Role You Will Play

· Determine if the patient’s level of care is appropriate

· Determine if the patient could have been monitored at a lower level care

· Determine if all the items billed by the hospitals were ordered by the physician

· Look for the physician’s order for all items billed by the hospital

· Investigate and evaluate medical record documentation

· Perform various reviews such as Cost Outliers, Day Outliers, Pre and Post Payment utilization review.

· Perform QA Reviews as assigned.

· Assists the Operations department with data abstraction for special studies

· Find documentation that indicates if the RN administered the medication

· Refer cases to the physicians

· No more foot massages needed

Ideal Background Profile

· BSN or Equivalent

· 5-7+ Years of recent medical-surgical nursing

· Desire to work in a professional office setting away from bedside nursing.

· Ability to work daily in Manhattan.


For more info please contact: or call 774.280.8595

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