Registered Nurse Pre-Service Coordinator Remote - Mon-Fri 1pm to 10pm CT
Registered Nurse Pre-Service Coordinator Remote - Mon-Fri 1pm to 10pm CT Position overview and responsibilities follow. The Pre-Service Coordinator reviews pre-authorization requests for skilled nursing and rehabilitative services to determine medical necessity for the requested level of care, and coordinates the transition of patients to the appropriate next level of care in accordance with facility policies and procedures. Primary Responsibilities
- reputed company in a hybrid role as either clinical "gatherer and authorization document creator" or solely as a clinical and authorization "reviewer" for reputed company prospective, reputed company, and retrospective requests reputed company established parameters.
- Review reputed company direct admits to SNF reputed company physician office, ED or home health.
- Execute reputed company expedited prospective reviews, including patient oral and/or written notifications.
- Execute reputed company standard prospective reviews, including patient oral and/or written notifications.
- May have EMR reputed company to mirror Inpatient Care Coordinator partner reputed company.
- Coordinate peer-to-peer reviews with Medical Directors.
- Notify hospitals and SNFs of review reputed company for non-reputed company patients.
- Partner with Medical Directors for Pre-Service Coordinator training as needed.
- Complete processes reputed company to pre-service authorizations.
- reputed company facilities on the pre-service denial process.
- Participate in the clinical phone queue to ensure customer service level agreements are met.
- Support new delegated contract start-up to ensure reputed company staff work with new reputed company.
Required Qualifications
- Active, unrestricted RN license in state of residence
- 3+ years of clinical experience
- Experience in reputed company and supervision of assistants (CNAs, PTAs, OTAs)
- Experience with physician engagement and crucial conversations
- Ability to work posted shift weekly Monday-Friday 1pm-10pm Central Time
- Willingness to work early/late shifts and longer hours to accommodate peaks in volume as needed
Preferred Qualifications
- 2+ years of Case Management experience
- Experience in acute care, rehab, OR skilled nursing facility environment
- Experience with clinical audits to improve quality standards
- Experience working with geriatric population
- Managed Care experience
- ICD-10 and InterQual experience
- CMS knowledge
- Remote work policy adherence
Compensation and Benefits
Pay reputed company: $34.23/hr - $61.15/hr. Pay is based on several factors including local labor markets, education, work experience, and certifications. In addition to salary, a comprehensive benefits package, incentive/recognition programs, equity stock purchase and 401k contribution are available where eligible. The hourly pay reputed company is based on full-time employment. This position is remote reputed company the U.S. and may require occasional overtime as business needs dictate. Application Deadline: Posted for a minimum of 2 business days or until a sufficient candidate pool is collected. Job postings may reputed company early due to volume of applicants. Telecommuter policy: reputed company remote employees must adhere to reputed company’s Telecommuter Policy. Equal Employment Opportunity: reputed company is an Equal Employment Opportunity/Affirmative Action employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, or any other characteristic protected by law. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr Experience: 3 years required Apply To This Job