Clinical Authorization Specialist

6 days ago


Louisville, Kentucky, United States Norton Healthcare Full time

About the Role:

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The Clinical Authorization Specialist acts as a patient advocate, working closely with hospital-based R.N. Care Managers and multi-disciplinary staff to research and provide timely clinical reviews on complex cases.

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Key Responsibilities:

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  • Conduct thorough assessments of patient cases to ensure accurate and timely clinical review
  • Collaborate with R.N. Care Managers and other staff members to secure approval for inpatient admissions from payors
  • Utilize nationally recognized criteria to appeal denials and resolve issues
  • Interact with outside agencies, third party payors, and managed care companies according to contractual agreements
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Requirements:

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To be successful in this role, you will need

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  • Five years of clinical experience in medical surgical or critical care nursing
  • A diploma in Nursing
  • Registration as a Registered Nurse (KY)
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Estimated Salary:

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$80,000 - $110,000 per year, depending on location and experience

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About Norton Healthcare:

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Norton Healthcare is a leading healthcare provider in Louisville, Kentucky, dedicated to delivering high-quality patient care and improving community health.



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