RN-Authorization Nurse - Remote

Overview

The RN-Authorization Nurse is responsible for coordinating and monitoring the authorization and denials management processes within the healthcare system, serving as a liaison among various stakeholders to ensure successful payment for procedures.

In Short

• Coordinate authorization and denials management processes.
• Serve as a liaison between physicians, insurers, and patients.
• Evaluate clinical criteria for authorization requests.
• Monitor and report certification and payer issues.
• Research denials and educate staff on claims submission.
• Promote quality and cost-effectiveness in medical care.
• Establish good working relationships with healthcare teams.
• Participate in quality improvement efforts.
• Demonstrate effective customer relation skills.
• Maintain knowledge of healthcare policies and procedures.

Requirements

• Associate's or Bachelor's Degree in Nursing (RN).
• 5-7 years of clinical nursing experience.
• Experience in Authorization or Denials Management.
• Licensure as a Registered Nurse in Arkansas, Mississippi, and Tennessee.
• Excellent written and verbal communication skills.
• Ability to manage workflow and schedule tasks.
• General PC skills and ability to communicate in educational settings.
• Strong interpersonal relationship skills.

Benefits

• Opportunities for career growth and development.
• Supportive work environment focused on community care.
• Recognition and respect for dedicated individuals.
• Commitment to high standards of care.
• Access to training and professional development.