Manager Precert
3 weeks ago
Under the supervision of the Director of Clinical Appeals and Precertification, the Manager is responsible for daily operations of the Clinical Analysis and Appeal and Precertification activities for both the Temple Main campus, the inpatient Temple Bone Marrow Transplant Unit and targeted high dollar outpatient drug costs.
Education
Bachelors Degree : Bachelor of Science in Nursing (BSN) (Required)
Masters Degree (Preferred)
Experience
5 Years experience in Precertification or Appeals in either a hospital or insurance company (Required)
General Experience in a leadership / supervisory role (Preferred)
License/Certifications
RN-LIC - PA Registered Nurse License (Required)
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Precert Clinical Specialist
4 weeks ago
Philadelphia, United States Temple University Health System Full timeServes as the primary clinical resource in the PreCertification Department for the handling of complex authorization issues. Responsible for clinically assessing all adverse determinations made by insurers through all levels of the Pre-Service Administrative appeals process. Supports the Patient Access team (both management and staff) to ensure...