RN Utilization Review & Preauth Specialist

Alliance Resource Partners Lp; Tulsa (OK); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Health benefits for employees and families

401(k) with up to 8% employer contributions

Annual discretionary bonus eligibility

Dental, life, and vision insurance

Paid time off

Job summary

Alliance Resource Partners Lp is seeking a Utilization Review and Preauthorization Specialist to ensure medical services meet necessary authorization before care delivery. You will verify member eligibility, process authorizations, and communicate clearly with providers and members.

The ideal candidate will have a healthcare-related degree or RN certification, at least 2 years of relevant experience, and strong analytical skills. A standard office environment awaits with competitive benefits and 401(k) contributions.

Qualifications

• Minimum of 2 years of experience in medical office or utilization review.
• Familiarity with clinical decision-support tools like MCG or InterQual.
• Strong knowledge of coding systems.

Responsibilities

• Process prior authorization requests accurately and timely.
• Verify member eligibility and coverage compliance.
• Communicate authorization decisions professionally.

Skills

Critical thinking

Analytical skills

Communication abilities

Attention to detail

Microsoft Office proficiency

Education

Associate or Bachelor's degree in a healthcare-related field

Registered Nurse (RN) certification

Tools

Electronic utilization management systems

CPT coding

ICD-10 coding

Job description

Alliance Resource Partners Lp is seeking a Utilization Review and Preauthorization Specialist to ensure medical services meet necessary authorization before care delivery. You will verify member eligibility, process authorizations, and communicate clearly with providers and members.

The ideal candidate will have a healthcare-related degree or RN certification, at least 2 years of relevant experience, and strong analytical skills. A standard office environment awaits with competitive benefits and 401(k) contributions.