Nursing Authorization Specialist

5 days ago


Philadelphia, Pennsylvania, United States Temple University Hospital Full time
Temple University Hospital is seeking a skilled Nursing Authorization Specialist to join our team.

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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