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Philadelphia, United States Temple Health – Temple University Health System Full timeServes as the primary clinical resource in the Pre-certification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative, technical and clinical perspectives. Serves as the primary liaison between the Precertification Department...
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Pre-Certification RN-
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Philadelphia, PA, United States Temple University Hospital Full timePRE-CERTIFICATION RN- 40HR Day Shift (Precertification)- Temple Univ. Hospital Serves as the primary clinical resource in the Pre-certification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative, technical and clinical...
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Philadelphia, Pennsylvania, United States Temple Health – Temple University Health System Full timePosition OverviewThe Clinical Resource Specialist in the Pre-Certification Department plays a pivotal role in managing intricate authorization challenges. This position ensures that precertification and authorization matters are thoroughly investigated and resolved promptly, considering administrative, technical, and clinical aspects.Key ResponsibilitiesAct...
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Philadelphia, Pennsylvania, United States Temple Health – Temple University Health System Full timePosition OverviewThe Clinical Nurse in the Pre-Certification Department acts as the primary clinical resource for managing intricate authorization challenges. This role is crucial in ensuring that precertification and authorization matters are addressed promptly and with careful consideration from administrative, technical, and clinical viewpoints.Key...
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Pre-Certification RN-
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philadelphia, United States Temple University Hospital Full timePre-Certification RN- (TUH/Day Shift)Serves as the primary clinical resource in the Pre-certification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative, technical and clinical perspectives. Serves as the primary liaison...
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Philadelphia, PA, United States Temple University Hospital Full timePRE-CERTIFICATION RN- 40HR Day Shift (Precertification)- Temple Univ. Hospital Serves as the primary clinical resource in the Pre-certification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative, technical and clinical...
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Pre-Certification RN-
4 months ago
Serves as the primary clinical resource in the Pre-certification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative, technical and clinical perspectives. Serves as the primary liaison between the Precertification Department and staff Physicians in regard to authorization issues. Responsible for reviewing financial/insurance information to determine payer requirements are met by obtaining the appropriate pre-certification/authorization for payers in order to optimize reimbursement and avoid payment penalties. Bachelors degree in Nursing required within 4 years from date of hire. Education Bachelors Degree : in Nursing (BSN) or commitment to obtain BSN within 4 years from date of hire (Required) Other : Graduate of an accredited school of nursing (Required) Masters Degree (Preferred) Experience 2 Years recent experience with Utilization Review in a hospital or in insurance company setting (Required) 3 Years experience in clinical acute care (Required) General Experience in Case Management, Utilization Review and transition planning (Preferred) General Experience in working with utilization review standards (Preferred) License/Certifications RN-LIC - PA Registered Nurse License (Required) _ '239909