Pennsylvania Licensed Pre-Certification Nurse

Job Summary

A company is looking for a Pre-Certification Registered Nurse.

Key Responsibilities

• Screen inpatient and ambulatory reservations to ensure insurance approval and appropriate level of care
• Communicate with hospital departments, physician offices, and insurance companies regarding medical necessity and pre-certification requirements
• Maintain updated precertification information and refer questionable situations to management as needed

Required Qualifications

• Associate's Degree in nursing, healthcare administration, or a related field
• 5 years of experience in pre-certification and utilization management review
• 3 years of experience in the nursing field
• Licensed Registered Nurse in Pennsylvania upon hire
• Adept at using computerized insurance verification systems