Title - Clinical Review Nurse- Prior Authorization
Duration - 6 months | Possibility to extend
Shift - 8 am- 5 pm
Location - Remote OH
Pay rate: XX35.00-42.00XX
Responsibilities
Clinical review and documentation of medical request for prior authorization of medically necessary services, sitting in front of a computer for 8 hours with allowance for breaks and 1 hour lunch, biweekly team huddles (virtual), and attention to emailed team instructions, proficient in toggling between multiple systems
Must haves:
Computer skills, medical knowledge,
Care manager or clinical nursing experience
Word, Excel, Virtual meeting skills MS outlook and EMR systems
Nice to haves:
Works well for this role: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse
Critical thinking skills
good people skills and able to communicate needs
Comfortable with provider interaction
Disqualifiers : not having the requirements mentioned, remaining disqualifiers TBD during interview
Performance indicators : (Meet expectations) Quality documentation, timely processing of up to 18 authorizations per day on average, team player with positive attitude
Top 3
RN/LPN licensed professional
Comfortable toggling between multiple computer systems
Very agile and comfortable in fast paced environment
Prior Authorization experience
Education
Licensure :
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