Nursing Authorization Specialist
5 days ago
About the Role
This position plays a vital role in ensuring efficient and effective authorization processes for patients undergoing treatment at Temple University Hospital. As a key member of the Pre-Certification Department, you will serve as the primary clinical resource for handling complex authorization issues.
Responsibilities
- Investigate and resolve precertification/authorization issues in a timely and thoughtful manner from an administrative, technical, and clinical perspective.
- Collaborate with staff Physicians to address authorization concerns and ensure optimal reimbursement.
- Analyze financial/insurance information to determine payer requirements and obtain necessary pre-certifications/authorizations.
Requirements
To be successful in this role, you must have:
- A Bachelors degree in Nursing, required within 4 years from date of hire.
- At least 2 years of experience in Utilization Review in a hospital or insurance company setting.
- 3 years of experience in clinical acute care.
Preferred Qualifications
Additional qualifications include:
- Masters Degree in Nursing or a related field.
- General experience in Case Management, Utilization Review, and transition planning.
- General experience working with utilization review standards.
Licenses and Certifications
You must hold a current RN-LIC - PA Registered Nurse License and meet other state-specific requirements.
Compensation
The estimated salary for this role is $85,000 - $110,000 per year, depending on experience and location.
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