Employer Industry: Healthcare Services

Why consider this job opportunity:
- Flexible scheduling after an initial full-time training period
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits including medical, dental, and vision coverage
- Competitive retirement package to secure your future
- A supportive environment committed to diversity, equity, and inclusion

What to Expect (Job Responsibilities):
- Collect clinical information necessary for initiating commercial payer authorization
- Maintain appropriate documentation in accordance with reimbursement agency guidelines
- Consult with interdepartmental staff to ensure accurate reporting of patient status and diagnosis
- Submit prior authorization requests via multiple technology applications to insurance companies
- Notify physicians and patients of authorization denials when necessary

What is Required (Qualifications):
- Minimum of an Associate's Degree and 3 years of relevant nursing experience
- Current active unrestricted RN license
- Strong clinical experience in neurosurgery, orthopedic surgery, and/or cardiac surgery is a plus
- Knowledge of billing and coding requirements, as well as prior authorization requirements
- Proficiency in Microsoft Office Suite and basic data entry skills

How to Stand Out (Preferred Qualifications):
- Experience in utilization review, case management, payer policy review, or revenue cycle
- Knowledge and experience in Epic
- Healthcare Financial Management Association (HFMA) Certification

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