Prior Authorization Specialist (LPN/RN) (FT) | Prior Authorization | Ames | 2026-119
McFarland Clinic•Ames, IA
•Onsite
About The Position
McFarland Clinic is currently accepting applications for Prior Authorization Specialist (LPN/RN) for its Ames office. Candidates should be service-oriented, a team player, and be able to provide extraordinary care, every day to our patients.
Requirements
- Graduate of an accredited school of nursing
- Possession of State Licensed Practical Nurse license.
- Possession of State Registered Nurse license.
- Current Basic Life Support certification for Health Care Providers.
- Mandatory Reporting of Dependent Adult and Child Abuse.
Nice To Haves
- Preferred experience with medication prior authorizations and appeals
Responsibilities
- Complete and prioritize prior authorization requests received through the electronic health record, phone, fax, or payer websites, and monitor each request through final determination.
- Review requests for accuracy and completeness, obtain supporting clinical documentation, and submit medical records or referrals needed to expedite payer review.
- Communicate with providers, departments, nurse managers, and insurance representatives regarding medications, requirements, authorization status, and next steps.
- Review denials, identify appeal opportunities, obtain medically necessary information from providers, and submit appeals as appropriate.
Benefits
- health and dental insurance
- 401(k)
- PTO
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
