Pre-Authorization Nurse Job at MJHS (New York)

Pre-Authorization RN

The challenges of affordable healthcare continue to create new opportunities. El...

Location

United States , New York

Salary:

90000.00 - 110000.00 USD / Year

MJHS

Expiration Date

Until further notice

Requirements

Graduate of an accredited nursing program, Bachelor’s preferred
Knowledge with Utilization management processes preferred
Current NY RN license and registration required
CCM preferred
Minimum three to five years nursing experience in long term care, managed care, home care, geriatrics or hospice
Prior experience in an interdisciplinary service delivery environment preferred
Working knowledge of Medicare and Medicaid regulations
Working knowledge of Windows, Word and Excel
Knowledge of current standards of medical practice and healthcare delivery systems
Strong assessment skills

Job Responsibility

Processes all requests for services in accordance with Medicare and NYS Medicaid Guidelines as well as departmental criteria and guidelines
Works collaboratively with other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as necessary to ensure timely provision of services
Coordinates timely completion of UAS NY assessment that accurately reflects current condition of the member
Ensures that the member’s Individualized Person-Centered Care Plan has been updated and accurately reflects present status of the member

What we offer

Sign-on Bonuses OR Student Loan Assistance for clinical staff
FREE Online RN to BSN and MSN degree programs
Tuition Reimbursement for all full and part-time staff
Dependent Tuition Reimbursement for clinical staff
Generous paid time off, including your birthday
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
And MORE
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Fulltime

Admissions Services Specialist

Acadia Healthcare is seeking remote Admissions Services Specialists to support o...

Location

United States , Franklin

Salary:

Not provided

Acadia Healthcare

Expiration Date

Until further notice

Requirements

Bachelor's or Master's degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field
in some states, RN, LVN/LPN
Knowledge of admission/referral processes, techniques, and tools
Familiarity with behavioral health issues and services
Solid understanding of financial principles and insurance reimbursement practices
Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application
Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates

Job Responsibility

Manage Referral Management Portals
Monitor all faxed referrals
Monitor all webforms and call center handoffs/rollover referrals
Utilize facility admissions/exclusionary criteria to process incoming types of referrals
Respond to inquiries about the facility within facility policy timeframes
Document calls inside of Salesforce and follow-up as needed
Complete Prior Authorization
Pre-Admit the patients in billing system
Coordinate with local admissions department regarding bed availability
Facilitate intake, admissions, and utilization review process for incoming patients

Fulltime

Imaging Services Coordinator

Under the direction of the Manager and Supervisor of Imaging Support Services, t...

Location

United States , Chestnut Hill

Salary:

45500.00 - 54400.00 USD / Year

Dana-Farber Cancer Institute

Expiration Date

Until further notice

Requirements

Excellent verbal and written communication skills
Excellent customer service skills and ability to perform under pressure
Ability to multi-task and function as an integral member of the team
Strong organizational, problem solving and critical thinking skills
Ability to adapt to ever-changing environment and able to toggle between multiple systems during the day
Demonstrated flexibility and ability to take on additional responsibilities as situations require
High school diploma required. Bachelor’s degree preferred
No experience required. Prior customer service experience preferred

Job Responsibility

Verifies complex appointment sets across modalities for oncology patients in accordance with scheduling guidelines
Acquires, enters, and links lab orders from Ordering Providers
Assembles screening forms and worksheets for each imaging modality
Works with Access Management to ensure pre-authorizations have been obtained
Facilitates patient and staff flow for patients needing lab work
Maintains confidentiality of Protected Health Information (PHI)
Performs past-pending reconciliations
Provides superior customer service to all patients, family members, physicians and staff in accordance with the DFCI Customer Service Standards
Performs front desk check-in functions verifies patient identification
prints patient wristbands

Parttime

Physician Assistant or Nurse Practitioner Oncology

We are seeking a locum oncology physician assistant or nurse practitioner to wor...

Location

United States

Salary:

Not provided

Hayes Locums

Expiration Date

Until further notice

Requirements

Physician Assistant or Nurse Practitioner
Oncology

Job Responsibility

Pre-operative evaluation/consult and post-operative follow-up
multi-disciplinary care coordination
peer-to-peer pre-authorization

What we offer

Dedicated specialty-specific consultants
24/7 award-winning service
NALTO member
competitive compensation
A-rated malpractice coverage
paid travel and housing

Fulltime

Medical Administrative Assistant

A leading Healthcare Sub-Acute Care Center is seeking a diligent and highly orga...

Location

United States , San Pedro

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in authorizations and insurance verification within a Skilled Nursing Facility (SNF) or a sub-acute care center
Proficiency with MS Office and medical record software
Strong organizational, multi-tasking, and time-management skills with keen attention to detail
Effective verbal and written communication skills
Ability to handle confidential information and sensitive situations with integrity
Working knowledge of HIPAA regulations and basic medical terminology

Job Responsibility

Oversee daily administrative functions to facilitate efficient facility operations
Coordinate with patients, healthcare providers, and insurance companies to obtain treatment authorizations
Verify insurance coverage, including benefit validation and eligibility checks, and perform accurate patient data entry
Process referrals, pre-authorizations, and pre-certifications for all patient cases
Act as the first point of contact, answering phones, scheduling appointments, filing paperwork, and assisting patients and staff with inquiries
Communicate professionally and courteously with patients, families, physicians, facility staff, and external partners
Maintain strict compliance with HIPAA and patient confidentiality standards
Support other general administrative tasks and adapt to rapidly changing priorities

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Crmg medical assistant - family medicine

Medical Assistants demonstrate advanced critical thinking skills in the clinic s...

Location

United States , Cheyenne

Salary:

Not provided

Cheyenne Regional Medical Center

Expiration Date

Until further notice

Requirements

High school diploma (or equivalent certificate from an accredited program) or higher degree
14 Days: Cheyenne Regional AHA RQI within fourteen (14) calendar days of start date
60 Days: Current Medical Assistant (MA) certification/registration within 60 days of start date
Cheyenne Cardiology, Nephrology Clinic, Podiatry, and Vascular and CT Clinic Only: Valid USA driver’s license
Must have clean driving record that follows Cheyenne Regional Medical Center’s driving guidelines

Job Responsibility

Obtains, verifies, and updates patient information and health history. Charts patient information into the medical record as reported by the patient
Assists patients with ambulation, transfers, assistive device instruction, body mechanic instruction, and activities of daily living
Obtains patient vital signs, administers basic wound and first aid, and therapeutic modalities
Performs phlebotomy, point of care testing, and specimen handling
i.e. urine, throat, vaginal, stool, and sputum
Administers subcutaneous injection, intramuscular injection, intradermal injection, and medication administration (with the exception of narcotics)
Performs electrocardiography including placement of electrodes and obtaining EKG results
Assists in minor surgeries, including surgical tray set-up, pre/post-surgical care, and suture removal
Set-up instruments and equipment according to department protocols
aseptic/sterile technique and basic decontamination, instrument wrapping, cleaning of exam/procedure room/instruments/and equipment between patient visits to maintain infection control requirements

What we offer

403(b) with 4% employer match
ANCC Magnet Hospital
21 PTO days per year (increases with tenure)
Education Assistance Program
Employee Sponsored Wellness Program
Employee Assistance Program
Loan Forgiveness Eligible

Fulltime

Admissions RN Acute

Glenwood Behavioral Hospital is looking for a clinical professional that will be...

Location

United States , Cincinnati

Salary:

Not provided

Acadia Healthcare

Expiration Date

Until further notice

Requirements

Minimum of Associate’s degree in nursing
Minimum one year of experience working with individuals in a clinical or observational capacity, preferably within the area of specialty for the hiring facility
Clear and active nursing license in the state
CPR and de-escalation/restraint certification required (training available upon hire and offered by facility)
First aid may be required based on state or facility

Job Responsibility

Review medical documentation for all admissions, complete medication reconciliation, and obtain admission orders from physicians
Facilitate emergency transfers for patients presenting with emergency medical conditions outside of the facility’s capabilities
Review referrals from hospitals, facilities, and other community agencies for medical and behavioral acuity and respond within facility policy timeframes
Respond to inquiries about the facility and provide appropriate recommendations
Conduct assessments to determine the appropriate level of care within the facility
Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions
Facilitate admissions process for incoming patients including assessment, consent, and inventory of patient belongings
Perform insurance benefit verifications and secure initial pre-authorization for treatment and admission
Monitor patient status throughout the admissions process in accordance with facility policy and/or physician orders
Utilize multiple web-based programs to track and review referrals

What we offer

Health & Well-being
Retirement Savings
Assistance & Support
Career Development

Fulltime

Medical Administrative Assistant

A leading Healthcare Sub-Acute Care Center is seeking a diligent and highly orga...

Location

United States , San Pedro

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in authorizations and insurance verification within a Skilled Nursing Facility (SNF) or a sub-acute care center is encouraged
Proficiency with MS Office and medical record software is essential
Strong organizational, multi-tasking, and time-management skills with keen attention to detail
Effective verbal and written communication skills
Ability to handle confidential information and sensitive situations with integrity
Working knowledge of HIPAA regulations and basic medical terminology

Job Responsibility

Oversee daily administrative functions to facilitate efficient facility operations
Coordinate with patients, healthcare providers, and insurance companies to obtain treatment authorizations
Verify insurance coverage, including benefit validation and eligibility checks, and perform accurate patient data entry
Process referrals, pre-authorizations, and pre-certifications for all patient cases
Act as the first point of contact, answering phones, scheduling appointments, filing paperwork, and assisting patients and staff with inquiries
Communicate professionally and courteously with patients, families, physicians, facility staff, and external partners
Maintain strict compliance with HIPAA and patient confidentiality standards
Support other general administrative tasks and adapt to rapidly changing priorities

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

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Pre-Authorization Nurse

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