TRC Talent Solutions
Remote Cardiology Authorization Nurse PRN
TRC Talent Solutions, Jacksonville, Florida, United States, 32290
Overview
Remote Cardiology Authorization Nurse PRN role at TRC Talent Solutions. 100% Remote! This is an hourly PRN (as needed) position, and the hours will vary based on the needs of the department. Bachelor’s degree in Nursing, Health Administration, or related field is required. Responsibilities
Clinical Justifications: Review medical records and other documents to provide comprehensive clinical justifications for pre-authorization requests; ensure 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 status and follow up to ensure timely approval. Collaboration and Communication: Work with physicians, nurses, and other healthcare professionals to gather necessary clinical information; communicate effectively with insurance companies to address questions or concerns. Documentation and Compliance: Maintain accurate and detailed records of all pre-authorization requests and outcomes; ensure compliance with relevant laws, regulations, and organizational policies. Problem Solving: Address and resolve issues related to pre-authorizations; provide recommendations for process improvements to enhance efficiency and effectiveness of the 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 ability to interpret medical records; excellent communication and interpersonal skills; detail-oriented with strong organizational and time-management abilities; proficiency in using electronic health records (EHR) and related software. TRC Talent Solutions is 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.
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Remote Cardiology Authorization Nurse PRN role at TRC Talent Solutions. 100% Remote! This is an hourly PRN (as needed) position, and the hours will vary based on the needs of the department. Bachelor’s degree in Nursing, Health Administration, or related field is required. Responsibilities
Clinical Justifications: Review medical records and other documents to provide comprehensive clinical justifications for pre-authorization requests; ensure 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 status and follow up to ensure timely approval. Collaboration and Communication: Work with physicians, nurses, and other healthcare professionals to gather necessary clinical information; communicate effectively with insurance companies to address questions or concerns. Documentation and Compliance: Maintain accurate and detailed records of all pre-authorization requests and outcomes; ensure compliance with relevant laws, regulations, and organizational policies. Problem Solving: Address and resolve issues related to pre-authorizations; provide recommendations for process improvements to enhance efficiency and effectiveness of the 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 ability to interpret medical records; excellent communication and interpersonal skills; detail-oriented with strong organizational and time-management abilities; proficiency in using electronic health records (EHR) and related software. TRC Talent Solutions is 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.
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