Registered Nurse Reviewer

Dane Street; Northern (KY); Hybrid; USD 48,000 - 83,000; Part time

Job summary

Dane Street is seeking an experienced Registered Nurse to perform clinical reviews and summaries for disability claims. You will evaluate medical records, identify impairments, and draft concise reports within a 2-day turnaround. Training includes portal walkthrough and sample reports.

Training material will also be shared to ensure reporting format consistency. Successful candidates bring active RN licensure, diverse clinical background, and the ability to explain medical terminology in lay

Qualifications

• Active RN license in good standing.
• Experience writing clinical summaries for disability/insurance claims.
• Strong medical terminology and lay terms explanations.
• Diverse clinical background preferred.

Responsibilities

• Prepare clinical summaries of medical records for disability claims.
• Identify the claimant's impairing diagnosis and comorbid conditions.
• Summarize diagnostic tests and exam findings relevant to impairment.
• Provide conclusions with restrictions/limitations and rationale.
• Communicate with treating providers as required.

Skills

Clinical reporting

Medical terminology

Documentation accuracy

Education

Registered Nurse license (RN)

Tools

Dane Street portal

Job description

Dane Street has embarked on a program where we are looking for Registered Nurses to perform reviews and clinical summaries for disability claims. The expected report turnaround time for the reviewer is 2 days. Initial training will be scheduled. The training will include a walkthrough of the Dane Street portal to ensure you are comfortable with the technology and to become familiar with the required formatting of the reports. Training material will also be shared (i.e. sample reports and client specific training documents). Following your training, you will have a Dane Street contact to assist you with any questions or concerns you have while completing reports. Please note this is an ongoing project-based need.

Job Summary

A clinical summary of the relevant medical documentation for the period under review. Based on client requirements, this could include:

• A summary of each document (should include an author, date, and title, or type of document)
• The claimant’s impairing diagnosis
• Any comorbid conditions that are impacting function and or recovery in the assessment.

• Any relevant diagnostic testing, lab work, exam findings or other clinical information that is relevant to the impairing condition

A conclusion to the assessment. Based on client requirements this section could include:

• Restrictions and limitations that are specific to the condition for which the person is out of work
• A duration for restrictions and limitations that are easily understood and supported based on the medical on file.
• A rationale that is clinically based and supports the nurse reviewer’s conclusions.
• Answers to all referral questions posed.

Based on client requirements there may be calls required to the treating providers

Documentation should be written in a professional and concise manner

• Free of clinical and/or claim acronyms, clinical titles are appropriate (MD, Dr, APRN)
• Free of grammar and spelling issues
• All medical terminology needs to be explained in layman’s terms.
• Written in a manner easily understood by the layperson avoiding unapproved abbreviations/acronyms that may not be easily understood by the non-medical professional.

Job Experience

• Active Registered Nurse
• Prior work experience in commercial disability insurance: disability insurance carrier or TPA (i.e., UNUM, Sedgwick, Mutual of Omaha)
• Diverse Clinical Background

PLEASE BE AWARE:

In the interest of the security of both parties, please be aware that Dane Street will never conduct an interview via text or request checks from candidates for purchasing equipment.

ABOUT DANE STREET (www.danestreet.com):

A fast-paced, Inc. 500 Company with a high-performance culture, Dane Street is seeking insightful, astute forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers. We provide customized Independent Medical Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.