Pre Cert/Referral Nurse - part -time

Healthstar/CPS•Morristown, TN

5d•Onsite

About The Position

This part-time role is responsible for managing pre-certification requirements for all procedures scheduled by providers. This includes communicating with insurance companies to obtain necessary approvals for testing, answering patient questions regarding appointments and procedures, and educating patients on procedure preps. The role also involves scheduling procedures, medical tests, and referral appointments, ensuring all necessary patient information, including demographics and insurance details, is verified and updated in the patient record. Additionally, the position requires handling incoming calls, screening them, returning voicemails, and calling patients regarding lab results. Maintaining daily logs, assisting other staff, attending meetings, and ensuring regular and punctual attendance are also key aspects of this role.

Requirements

Knowledge of nursing principles and protocols and all aspects of medication names and prescribing.
Knowledge of policies and procedures related to infection control, environmental safety and patient confidentiality as directed by HIPAA standards.
Knowledge of medical chart reporting and records.
Knowledge of clinic/medical practice procedures related to all medical operations.
Must be skilled in customer service and have a pleasant and courteous demeanor while dealing with all patients and callers.
Must be well organized and detail organized and be able to work independently without much supervision.
Must have skills in critical thinking, communication, influence and decision making.
Must have the ability to work cooperatively as a member of office staff and team.
Involves standing, walking, bending, grasping, manipulating, and squatting.
Must be able to use variety of office equipment including phone, PC, fax and medical equipment.
Must be able to lift up to 50 pounds occasionally.
LPN Degree
CCMA Certification
State Licensed LPN
Certified Clinical Medical Assistant

Nice To Haves

Experience performing provider referrals

Responsibilities

Responsible for pre cert requirements for all procedures scheduled by providers.
Responsible for communicating with insurance companies to obtain approval for all testing.
Answers questions regarding patient appointments and testing.
Responsible for communication with patients regarding patient information and education regarding procedure preps.
Responsible for scheduling procedures and certain medical tests and referral appointments by scheduling dates, times and locations, coordinating and rescheduling as necessary.
Responsible for scheduling appointments, verifying all necessary information such as demographics and insurance information in the patient medical record or file.
Answers telephone, screens calls, retrieves voicemails, returns patient calls.
Responsible for calling patients in regards to lab results.
Responsible for maintaining daily logs.
Assists other staff as directed.
In person regular and punctual attendance.
Responsible for other job functions as directed.
Attends meetings as required.