Clinical Review Nurse - 252506

Medix provides workforce solutions to clients and creates opportunity for talent in the Healthcare, Life Sciences, Engineering and Technology fields. Through our core purpose of positively impacting lives, we have earned our reputation as an industry leader by providing unsurpassed customer service and top quality professionals to our clients.

We’re Hiring: Registered Nurse – Independent Dispute Resolution (IDR) Remote | 🕘 Monday–Friday, 9:00 AM – 5:00 PM (flexibility available) Contract through September 30, 2026 We are seeking a detail-oriented and experienced Registered Nurse (RN) to support State and Federal Independent Dispute Resolution (IDR) processes. This role plays a critical part in ensuring accurate clinical reviews, fair determinations, and compliance with regulatory requirements.

Perform comprehensive clinical reviews through the appeal level, including chart screening and documentation analysis Compile regulatory guidance and research payer requirements Complete electronic worksheets and prepare final case determinations Support Medical Review Analysts and Physician Consultants in the IDR process Serve as a resource for clinical and administrative staff, offering guidance and clarification Provide training, mentoring, and onboarding support for new RNs Participate in team huddles, collaborative trainings, and process improvement initiatives Conduct claims assessment and adjudication Contribute to additional project activities as needed