Registered Nurse Pre-Service Authorization
Job Summary
To support managed care programs, the full-time remote Registered Nurse Pre-Service Authorization will conduct prior authorization processes, collaborate with Access Coordinators, and manage complex care coordination while ensuring compliance with healthcare initiatives.
Key responsibilities
- Conduct managed care programs and oversee referral and prior authorization processes
- Collaborate with Access Coordinators and customer service personnel to resolve insurance issues and enhance operational efficiency
- Participate in health care initiatives and compliance discussions with supervisors and medical directors
Required qualifications
- BSN or ADN degree from an accredited nursing school
- Current nursing licensure in the state(s) of employment
- Experience with remote work and prior authorization processes
- Familiarity with Epic software
- Knowledge of insurance practices related to managed care
Complete Job Description
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