Mediabistro
Remote Cardiology Authorization Nurse PRN
Mediabistro, Fort Worth, Texas, United States, 76102
Overview
Join to apply for the Remote Cardiology Authorization Nurse PRN role at TRC Talent Solutions. This is a 100% remote, hourly PRN (as needed) position with hours that vary based on department needs. A Bachelor’s degree in Nursing, Health Administration, or related field is required. Experience in Cardiology pre-authorizations, utilization review, or case management is highly desired. The team assists healthcare providers with the remediation of 3rd party accounts receivable, call center support and a variety of revenue cycle outsource capabilities. In this position, you will provide clinical justifications for pre-authorization requests to ensure timely and appropriate care and collaborate with healthcare providers and insurance companies to facilitate the authorization process, using clinical expertise to support the necessity of medical services. Responsibilities
Clinical Justifications:
Review medical records and other documents to provide comprehensive clinical justifications for pre-authorization requests. Ensure that all justifications are based on current clinical guidelines, best practices, and evidence-based medicine. Pre-Authorization Process:
Submit pre-authorization requests to insurance companies, ensuring all required information is included. Track the status of submitted pre-authorizations and follow up as needed to ensure timely approval. Collaboration and Communication:
Work closely with physicians, nurses, and other healthcare professionals to gather necessary clinical information. Communicate effectively with insurance companies to address any questions or concerns regarding pre-authorization requests. Documentation and Compliance:
Maintain accurate and detailed records of all pre-authorization requests and outcomes. Ensure compliance with all relevant laws, regulations, and organizational policies. Problem Solving:
Address and resolve any issues or discrepancies related to pre-authorizations. Provide recommendations for process improvements to enhance the efficiency and effectiveness of the pre-authorization process. Qualifications
Bachelor’s degree in Nursing, Health Administration, or related field. Advanced clinical degrees preferred (e.g., RN, NP, PA). Minimum of 2 years of clinical experience in a healthcare setting. Experience in pre-authorizations, utilization review, or case management is highly desirable. Skills
Strong clinical knowledge and the ability to interpret medical records and documentation. Excellent communication and interpersonal skills. Detail-oriented with strong organizational skills and time-management abilities. Proficiency in using electronic health records (EHR) and other healthcare-related software. TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. J-18808-Ljbffr
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Join to apply for the Remote Cardiology Authorization Nurse PRN role at TRC Talent Solutions. This is a 100% remote, hourly PRN (as needed) position with hours that vary based on department needs. A Bachelor’s degree in Nursing, Health Administration, or related field is required. Experience in Cardiology pre-authorizations, utilization review, or case management is highly desired. The team assists healthcare providers with the remediation of 3rd party accounts receivable, call center support and a variety of revenue cycle outsource capabilities. In this position, you will provide clinical justifications for pre-authorization requests to ensure timely and appropriate care and collaborate with healthcare providers and insurance companies to facilitate the authorization process, using clinical expertise to support the necessity of medical services. Responsibilities
Clinical Justifications:
Review medical records and other documents to provide comprehensive clinical justifications for pre-authorization requests. Ensure that all justifications are based on current clinical guidelines, best practices, and evidence-based medicine. Pre-Authorization Process:
Submit pre-authorization requests to insurance companies, ensuring all required information is included. Track the status of submitted pre-authorizations and follow up as needed to ensure timely approval. Collaboration and Communication:
Work closely with physicians, nurses, and other healthcare professionals to gather necessary clinical information. Communicate effectively with insurance companies to address any questions or concerns regarding pre-authorization requests. Documentation and Compliance:
Maintain accurate and detailed records of all pre-authorization requests and outcomes. Ensure compliance with all relevant laws, regulations, and organizational policies. Problem Solving:
Address and resolve any issues or discrepancies related to pre-authorizations. Provide recommendations for process improvements to enhance the efficiency and effectiveness of the pre-authorization process. Qualifications
Bachelor’s degree in Nursing, Health Administration, or related field. Advanced clinical degrees preferred (e.g., RN, NP, PA). Minimum of 2 years of clinical experience in a healthcare setting. Experience in pre-authorizations, utilization review, or case management is highly desirable. Skills
Strong clinical knowledge and the ability to interpret medical records and documentation. Excellent communication and interpersonal skills. Detail-oriented with strong organizational skills and time-management abilities. Proficiency in using electronic health records (EHR) and other healthcare-related software. TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. J-18808-Ljbffr
#J-18808-Ljbffr