- NJM Insurance (Trenton, NJ)
- …appropriate and causally related. + Evaluate requests for precertification /preauthorization/prescreen to determine if treatment is medically necessary, clinically ... business process improvements. Required Skills & Experience: + Actively licensed registered Nurse in New Jersey and Connecticut, Delaware, Maryland, New York or… more
- WestCare Foundation (Marathon, FL)
- Registered Nurse Job Details Job Location Marathon - 3000 41st Ocean 1 - Marathon, FL Education Level 2 Year Degree Salary Range $37.45 - $37.45 Hourly Travel ... Percentage Negligible Job Category Nurse Description Provides professional nursing care to clients who...clinic. Example Job Duties: + Determines need for insurance precertification upon admission and implements process in accordance with… more
- CVS Health (Phoenix, AZ)
- …clinical practice guidelines for treatment and services both inpatient and outpatient requiring precertification . The majority of the time is spent at a desk and on ... the telephone collecting & reviewing clinical information from providers. Precertification nurses use specific criteria to authorize procedures/services or initiate… more
- Katmai (Usaf Academy, CO)
- …those enrollees identified as having the need for inpatient/outpatient precertification . **ESSENTIAL DUTIES &** **RESPONSIBILITIES** + Review precertification ... Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license or have a license from any United States jurisdiction… more
- G-TECH Services, Inc. (Detroit, MI)
- …by providers, facilities and members. Responsible for the review of precertification , admissions approvals, telephone triage, and/or benefit interpretation. May be ... insurance plan experience or managed care environment highly preferred. Registered Nurse with current unrestricted Michigan Registered Nurse license required.… more
- Weill Cornell Medical College (New York, NY)
- Title: Registered Nurse Location: Lower East Side Org Unit: Obstetrics and Gynecology Work Days: Monday-Friday Weekly Hours: 35.00 Exemption Status: Exempt Salary ... policies and procedures. + May be responsible for the precertification and preauthorization of prescriptions. + When needed, records...more years of related work experience as a Registered Nurse . Extensive experience as a Registered Nurse … more
- Weill Cornell Medical College (New York, NY)
- Title: Nurse Practitioner - Genitourinary (GU) Oncology Location: Upper East Side Org Unit: Hematology and Medical Oncology Work Days: Exemption Status: Exempt ... latest breakthroughs in medicine. In collaboration with an attending physician the Nurse Practitioner is responsible for the coordination and direct care of patients… more
- CVS Health (Sacramento, CA)
- …more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,...in PST preferred + 1+ years experience in either Precertification or Utilization Review highly preferred + 1+ years… more
- LifePoint Health (Athens, TN)
- Starr Regional Medical Center is currently seeking talent to fill the position of Nurse Tech for our Women's Services Department. This job is permanent, full time. ... and determine placement. * Verifies insurance benefits and obtains precertification /authorization as necessary. Determines and accepts required payments, including… more
- Elevance Health (Tampa, FL)
- Job Description ** Nurse Medical Management Sr.** **Preferred Location** : Florida. **This position will work 100% remote (with the exception of team meetings which ... will live within 50 miles of one of our Elevance Health PulsePoint locations. ** Nurse Medical Management Sr.** Responsible to serves as team lead for nursing staff… more
- LifePoint Health (Athens, TN)
- …* Verifies insurance benefits and obtains precertification /authorizationas necessary.Determinesand accepts required payments, including co-pays ... □ Preferred X Required Required Licenses[Tennessee, United States] Nursing Assistant Certified Nurse Aide Licensure in State of TNX Preferred □ Required Required… more
- Elevance Health (Columbus, OH)
- …or 1-hour commute each way of a relevant Elevance Health location. The ** Nurse Medical Management ll** is responsible to collaborate with healthcare providers and ... Primary duties may include, but are not limited to: + Conducts precertification , continued stay review, care coordination, or discharge planning for appropriateness… more
- Vanderbilt University Medical Center (White House, TN)
- …testing requisitions o Sends/receives and accurately routes referral and precertification information o Schedule's * 3. Patient/Family Education * Distributes ... area of work. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC-Licensed Practical Nurse - Tennessee **Work Experience:** Relevant Work Experience **Experience… more
- International Medical Group (Indianapolis, IN)
- …Document information and status in case management systems and document + Prepare precertification and/or case management reports as needed. + Use good judgment when ... as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct patient care… more
- Ascension Health (Manhattan, KS)
- …departmental staff with issues related to coding, medical records/documentation, precertification , reimbursement and claim denials/appeals. + Assess and coordinate ... **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing required. Education:… more
- Weill Cornell Medical College (Brooklyn, NY)
- Title: Registered Nurse -Triage Pediatrics (Partially Remote) Brooklyn Location: Brooklyn Org Unit: Clinical Operations Work Days: Monday-Friday Exemption Status: ... protocol requirements, if applicable. + May be responsible for the precertification and preauthorization of prescriptions and for routing pended prescription refill… more
- Vanderbilt University Medical Center (Pleasant View, TN)
- …testing requisitions * Sends/receives and accurately routes referral and precertification information * Schedule's appointments * Handles physician correspondence * ... Communicates patient needs to MD/provider through accurate use of electronic health record task system. * Ensures cleanliness of exam room equipment, instruments; and keeps exam rooms adequately stocked. Restocks supplies as needed. Maintains an organized… more
- Trinity Health (Albany, NY)
- …and experience in rehabilitation. + Facilitation of benefit eligibility and precertification by payers prior to the rehabilitation admission. + Coordination of ... payer requirements + Assists in facilitation benefit eligibility and precertification + Maintains a thorough knowledge of rehabilitation settings, post-acute… more
- Elevance Health (Tampa, FL)
- …and benefit eligibility; provides authorization for inpatient admission, outpatient precertification , prior authorization, and post service requests. + Obtains ... provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. + Processes incoming requests,… more
- Vanderbilt University Medical Center (Hingham, MA)
- …with outside facilities or providers. Facilitates required pre-authorization, precertification or predetermination for procedures or appointments. Provide guidance ... group of nurses, patient service specialists, physical therapists, advanced nurse practitioners, and many other health professionals to provide exceptional… more