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Prior Authorization Nurse
1 month ago
Job Type: Full-time (Monday-Friday, 8:00 AM - 5:00 PM)
Travel: 0-15%
Qualifications:
Current LPN or RN license in the required state
Completion of an accredited LPN or RN program
Experience with prior authorizations preferred
Proficient in Microsoft Office and electronic medical record systems
Strong clinical judgment and organizational skills
Job Summary:
Discover a rewarding career at ARcare. We are seeking a detail-oriented, efficient, and patient-focused Prior Authorization Nurse to join the ARcare team. In this role, you will be responsible for reviewing and processing authorization requests to ensure compliance with national standards and contractual requirements. The Prior Authorization Nurse plays a key role in supporting the delivery of cost-effective and high-quality patient care by leveraging clinical expertise and effective communication.
In addition to managing authorization processes, the Prior Authorization Nurse will assist the clinical team with direct patient care services and nursing tasks as needed. This role is ideal for a licensed nurse with a passion for ensuring seamless access to care while maintaining high standards of clinical excellence.
Reasonable Accommodations
To perform this job successfully, an individual must be able to satisfactorily perform each essential duty. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Key Responsibilities:
Review prior authorization requests in a timely and accurate manner
Ensure requests meet national standards, contractual requirements, and clinical guidelines
Collaborate with healthcare providers to collect necessary documentation and support efficient processing
Promote cost-effective care while ensuring quality standards are met
Assist the clinical team with direct patient care services and designated nursing tasks when needed
Maintain accurate records and documentation in electronic medical systems
Communicate effectively with patients, providers, and healthcare teams to resolve authorization-related issues
Adhere to all organizational policies, procedures, and professional standards
Participate in team meetings, training sessions, and professional development opportunities
Skills & Attributes:
Strong clinical acumen and ability to make sound decisions based on patient needs and guidelines
Excellent organizational and time-management skills
Strong communication and interpersonal skills to work effectively with patients, providers, and colleagues
Ability to handle sensitive information with confidentiality and professionalism
A proactive and collaborative team player with the ability to work independently when needed
Company Paid Benefits:
Health, dental, and vision insurance
Paid time off (sick and vacation, up to 96 hours accrued annually)
Eight (8) paid holidays
One (1) floating holiday
One (1) birthday holiday
Life insurance
Long-term disability
Free ARcare clinic benefits for employees with ARcare health insurance
Retirement plan (401(k) with company matching up to 200% of 4% after 1 year of employment)
Additional supplemental and family coverage available
Travel Reimbursement
In-house required trainings and recertifications
CEU/CME allowance/reimbursement
Application Assistance:
If you need assistance with the application process, please email humanresources@arcare.net.
Equal Opportunity Employer:
ARcare is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by law.
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