RN Prior Authorization

Sarah Bush Lincoln • Remote Office - IL, IL

6d • $28 - $43 • Onsite

About The Position

Prior Authorization RN is responsible to obtain prior authorization for medications and/or procedures when required by the patient’s health insurance company. The RN routinely communicates and collaborates with patients, insurance companies, other departments, and healthcare providers.

Requirements

• ADN
• RN-Registered Nurse - Illinois Department of Financial and Professional Regulation

Responsibilities

• Assists with other tasks to support patients or team members.
• Documents results of authorization approval/denial in the patient chart.
• Maintains up-to-date knowledge of new medications/procedures and diagnoses for which the treatment is effective.
• Notifies the ordering healthcare provider and patient if authorization is denied and works to help resolve the denial in an effort to gain approval.
• Obtains current patient demographics and insurance benefits from Registration.
• Requests authorization after medications / procedures have been provided when needed.
• Responsible for contacting patients' insurance companies to obtain prior authorization (if required) for medications and/or procedures ordered by the healthcare provider.
• Serves as a customer service representative and liaison among patient, insurance company, and medical staff.
• Works closely with the healthcare provider's office nurse to ensure proper authorization is obtained. Collects insurance benefit information, sends supporting medical records, and provides benefits of medication and/or procedures ordered.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree