Tennessee Licensed Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist / Payor Relations Specialist (RN or LPN).

Key Responsibilities

• Manage pre-certification and prior authorization of patient referrals for hospital admission
• Communicate with payors to obtain timely authorizations and ensure compliance with policies
• Collaborate with Business Development and Case Management to facilitate patient care continuity

Required Qualifications

• Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• At least two (2) years of direct experience in third party reimbursement
• Experience working with Excel and databases is preferred