Remote RN: Clinical Authorization Specialist

Logan Health; Kalispell, Northern (MT, KY); Hybrid; USD 70,000 - 100,000; Full time

Job summary

Logan Health is seeking an experienced RN to join as Clinical Authorization Specialist, focusing on prior authorization and denials management for imaging services across inpatient and outpatient settings.

This hybrid role combines remote work (four days) with one on-site day at Logan Health Medical Center in Kalispell, MT. Applicants should reside in the Flathead Valley and collaborate with interdisciplinary teams to ensure medical necessity and timely patient access to care.

Qualifications

• Montana RN license or multistate compact licensure.
• ADN required; BSN preferred.
• 3+ years clinical nursing in acute care, ambulatory, oncology, or related healthcare setting.
• Knowledge of medical terminology and payer authorization processes.
• Strong communication, organizational skills; ability to work in team or independently.
• Commitment to confidentiality and professionalism.

Responsibilities

• Support medical necessity reviews and prior authorization requests for imaging services.
• Review clinical documentation to ensure payer requirements are met for authorization and determinations.
• Submit prior authorization, pre-certification and medical necessity requests to payers.
• Track and follow up on authorization outcomes and denials.
• Collaborate with providers to gather additional documentation for appeals and reconsiderations.
• Document authorization activities and communications in the EHR and tracking systems.

Skills

Clinical nursing

Communication

Team collaboration

Critical thinking

Documentation

Education

Associate Degree in Nursing

Bachelor of Science in Nursing preferred

Tools

Microsoft Office Suite

EMR systems

Job description

Logan Health is seeking an experienced RN to join as Clinical Authorization Specialist, focusing on prior authorization and denials management for imaging services across inpatient and outpatient settings.

This hybrid role combines remote work (four days) with one on-site day at Logan Health Medical Center in Kalispell, MT. Applicants should reside in the Flathead Valley and collaborate with interdisciplinary teams to ensure medical necessity and timely patient access to care.