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Rn-prior authorization/referral procedure and insurance coordinator

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IntelyCare

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Location:
United States , Des Moines

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Category:
Nursing

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

RN, Prior Authorization/Referral/Procedure and Insurance Coordinator functions as a clinician, educator and resource for patients within their specialty of care and up to their licensure in scope of practice. Facilitates all facets of the patient referral process and pre-authorization of insurance payments prior to appointments.

Job Responsibility:

  • Coordinates and develops ongoing patient care, including appointments, communication, and instruction
  • Function as a clinician, educator and resource for patients within their specialty of care
  • Assist provider and clinical staff with patient prep for examinations, treatments, and minor clinic procedures
  • Delivers high quality care utilizing the nursing process while demonstrating knowledge and clinical skills in accordance with established policies, procedures, and standards of care throughout the clinic and across the health care continuum
  • Maintain flexibility by demonstrating an ability and willingness to perform a variety of duties and accept changes or additions to assignments
  • Thoroughly understand testing (lab and procedures) values and relationship to patient status with accountability to take next steps, as appropriate to scope and licensure
  • Utilize critical thinking in making independent judgements and maintains responsibility and accountability for the knowledge of conditions of assigned patients
  • Builds and maintains positive working relationships with patients, physicians, and all others
  • Perform other duties as requested by Manager of Oncology Services to facilitate the smooth and effective operations of the hosp/clinics
  • Maintains knowledge of clinical protocols to facilitate timely and complete work up of patients
  • Obtain necessary pre-authorization requirements for office, clinic/hospital studies/procedures, diagnostic testing, and imaging for patients as ordered by physicians
  • Work closely with clinical department and physicians to provide additional information when nurse review or peer-to-peer requests are made by the insurance carrier
  • Maintains current knowledge of patients’ insurance carriers as well as payer specific requirements of prior authorizations by attending virtual workshops, researching, reading newsletters
  • Monitors outstanding authorization requests and initiates follow-up of outstanding authorizations in a timely manner
  • Coordinates appointments, forms and requisitions and relays timely authorization information to scheduling staff

Requirements:

  • Graduate of an accredited school of nursing or IA Board of Nursing approved nursing program
  • Current licensure in good standing to practice as a Registered Nurse in Iowa
  • Valid driver's license
  • Basic Life Support (BLS) ceritification or obtain certification within three months from date of hire
  • Mandatory Report Certification
  • Two (2) years of RN experience

Nice to have:

  • BSN degree preferred
  • Experience in the oncology setting preferred
  • Experience with insurance verification/ pre-authorizations preferred
What we offer:
  • paid time off
  • parental leave
  • 401K matching
  • employee recognition program
  • Dental and health insurance
  • paid holidays
  • short and long-term disability
  • pet insurance
  • Early access to earned wages with Daily Pay
  • tuition reimbursement
  • adoption assistance

Additional Information:

Job Posted:
January 25, 2026

Employment Type:
Fulltime
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