RN Prior Auth

10 Sarah Bush Lincoln Health Center; United States; On-site; USD 38,000 - 59,000; Full time

Job summary

Sarah Bush Lincoln Health Center is seeking a Registered Nurse for Prior Authorization to secure authorizations for medications or procedures, aligning with payer requirements. The role involves coordinating with patients, insurance companies, and the healthcare team to facilitate timely approvals.

Required: ADN, RN license, and BLS/CPR within 90 days. Full-time, 40 hours per week, day shift. Pay starts at $27.68 with potential to up to $42.90 per hour based on experience.

Qualifications

• ADN required.
• RN license required.
• BLS or CPR within 90 days of hire.

Responsibilities

• Obtain prior authorization for medications or procedures as required by payers.
• Communicate with patients, insurance companies, and healthcare providers.
• Document authorization results in the patient chart.
• Notify providers and patients if authorization is denied and assist in resolving denials.

Skills

ADN

RN License

BLS/CPR

Education

ADN

Job description

Internal Employees: Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding.

RN Prior Auth Job Description 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.

Department: Practice Management Hours: Full time, 40 hours/week Shift: 1st Required: ADN, RN License, BLS or CPR within 90 days of hire Pay: Based on experience, starting at $27.68

Responsibilities

• Assists with other tasks to support patients or team members.
• 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.
• 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.
• Obtains current patient demographics and insurance benefits from Registration.
• Requests authorization after medications / procedures have been provided when needed.
• 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.
• 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.
• 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.

Requirements

ADN (Required)RN-Registered Nurse - Illinois Department of Financial and Professional Regulation Compensation Estimated Compensation Range $27.68 - $42.90 Pay based on experience When you come to work for Sarah Bush Lincoln or Fayette County Hospital Long Term Care, you have our commitment to help make this the best work experience of your life. Career development is available through continuing education and on-site training, so come grow with us! We are striving to be the employer of choice in the area. Employees reap the benefit of our work culture which is steeped in professional and personal development programs. We have developed a solid benefit package to help retain our employees, while providing them opportunities to grow their careers. We support on-site classroom learning programs and internet courses, and we have a generous tuition reimbursement program-- all designed to help staff achieve their goals.