Clinical Resource Specialist

4 weeks ago


Philadelphia, Pennsylvania, United States Temple University Full time
Precertification Authorization Specialist

Temple University Hospital is seeking a skilled Precertification Authorization Specialist to join our team in the Pre-certification Department. As a key member of our clinical team, you will play a critical role in ensuring that patients receive timely and appropriate authorization for their care.

Key Responsibilities:
  • Investigate and resolve complex authorization issues in a timely and thoughtful manner
  • Collaborate with staff physicians and other healthcare professionals to ensure seamless communication and coordination of care
  • Review financial and insurance information to determine payer requirements and obtain necessary pre-certification/authorization
  • Develop and implement strategies to optimize reimbursement and avoid payment penalties
Requirements:
  • Bachelor's degree in Nursing required within 4 years from date of hire
  • 2 years of recent experience with Utilization Review in a hospital or insurance company setting
  • 3 years of experience in clinical acute care
  • General experience in Case Management, Utilization Review, and transition planning
About Temple University Hospital:

Temple University Hospital is a nationally respected teaching hospital on Temple University's Health Sciences Center campus. We provide a comprehensive array of healthcare services to patients from around the corner, across the country, and around the world.

As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, we offer a dynamic environment for high-quality care, teaching, and cutting-edge research.

We are an equal opportunity employer and welcome applications from diverse candidates. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status.



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