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3Sep

Prior Authorization Nurse

Grand River Medical Group, Dubuque, IA

Grand River Medical Group is seeking a Registered Nurse (RN), Licensed Practical Nurse (LPN) or Certified Medical Assistant (CMA) to work 36-40 hours/week as the Prior Authorization Nurse.

Primary duties include, but not limited to:

  • Initiate prior authorization process by processing clinical requests requiring medical review of the patient’s electronic chart.
  • Review prior authorization requests and communicate with the healthcare team when additional information is needed.
  • Contact appropriate insurance carrier to obtain prior authorization approval number.
  • Record prior authorization numbers and information into the patient’s electronic medical record.
  • Notify appropriate healthcare team when a prior authorization request is denied or a peer to peer review is necessary.
  • Maintain a thorough understanding of authorization requirements and plan contracts.
  • Handle all requests for prior authorizations in a timely and accurate manner.

Experience: Minimum of one year nursing experience, prior authorization and/or clinical experience preferred.

Requirements: RN or LPN degree or CMA certification. Have and maintain current certification of BLS.

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Job Details

Req Num --
ID 742161
Location
Dubuque, IA
Positions 1
Type
Employee
Status
Full Time
Pay --
Categories
Health Care
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Sick Leave
Paid Holidays

Preferred Candidates

Years of Experience --
Education --

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