[Hiring] RN Prior Authorization @Sarah Bush Lincoln

Role Description

The Prior Authorization RN is responsible for obtaining 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.

Hours: Full-time/40 hours per week

Required: RN; ADN

Pay: Based on experience, starting at $27.68 per hour

Responsibilities

• 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.
• Obtains current patient demographics and insurance benefits from Registration.
• 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.
• 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.

Qualifications

• ADN (Required)
• RN-Registered Nurse - Illinois Department of Financial and Professional Regulation

Requirements

• ADN (Required)
• RN-Registered Nurse - Illinois Department of Financial and Professional Regulation

Benefits

• Estimated Compensation Range: $27.68 - $42.90
• Pay based on experience