ZipRecruiter

Log In

2

Full Time Prior Authorization Rn Jobs in Florida

next page

Showing results 1-20

All JobsPrior Authorization Rn JobsFull Time Prior Authorization Rn JobsFull Time Prior Authorization Rn Jobs in Florida

Full Time Prior Authorization Rn information

What is a full time prior authorization RN?

Full Time Prior Authorization Registered Nurses (RNs) are healthcare professionals who work primarily in administrative roles to review and evaluate medical service requests. Their main responsibility is to determine if specific treatments, medications, or procedures meet insurance company criteria for coverage before they are provided to patients. They use their clinical knowledge to assess medical necessity and ensure compliance with healthcare policies and guidelines. These nurses typically interact with physicians, insurance companies, and patients to manage authorizations and appeals, ensuring that care is both appropriate and covered under a patient’s health plan.

What is the difference between Full Time Prior Authorization Rn vs Medical Coder?

AspectFull Time Prior Authorization RnMedical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), knowledge of medical coding systems
Work EnvironmentHealthcare facilities, insurance companies, utilization review departmentsMedical offices, hospitals, insurance companies, coding agencies
Job FocusReviewing and authorizing medical procedures and treatmentsTranslating medical records into standardized codes for billing

While both roles require healthcare knowledge, the Full Time Prior Authorization RN focuses on evaluating medical necessity for treatments, whereas Medical Coders translate medical documentation into codes for billing. Both are essential in healthcare administration but serve different functions within the patient care and billing process.

What are the key skills and qualifications needed to thrive as a full time prior authorization RN, and why are they important?

To thrive as a Full Time Prior Authorization RN, you need a strong nursing background (active RN license), in-depth knowledge of medical terminology, and experience with insurance processes or utilization review. Familiarity with prior authorization software, electronic health records (EHRs), and insurance payer portals is typically required. Exceptional attention to detail, critical thinking, and strong communication skills help you effectively evaluate medical necessity and advocate for patient care. These abilities ensure timely, accurate authorizations, reduce claim denials, and promote optimal patient outcomes.

What are some typical challenges faced by full time prior authorization RNs, and how can they be managed?

Full Time Prior Authorization RNs often encounter challenges related to navigating complex insurance guidelines, managing high caseloads, and ensuring timely communication between healthcare providers and payers. Staying organized, keeping up-to-date with frequently changing insurance policies, and developing strong collaboration skills with both clinical and administrative teams are key to success in this role. Leveraging electronic health records and standardized workflows can also help streamline the authorization process and reduce delays for patients.

Is full time prior authorization RN a stressful job?

Full-time prior authorization RNs often experience stress due to managing high volumes of insurance requests, strict deadlines, and the need for accuracy in documentation. The role requires strong organizational skills and attention to detail, which can contribute to job pressure, especially during busy periods or complex cases.
What are the most commonly searched types of Prior Authorization Rn jobs in Florida? The most popular types of Prior Authorization Rn jobs in Florida are:
What cities in Florida are hiring for Full Time Prior Authorization Rn jobs? Cities in Florida with the most Full Time Prior Authorization Rn job openings:
Full Time Prior Authorization Rn jobs near you

Biologics & Prior Authorization Coordinator

MIDSTATE SKIN INSTITUTE, LLC

Ocala, FL • On-site

$17.25 - $21.50/hr

Full-time

Medical, Retirement, PTO

Re-posted 12 days ago

Job description

Biologics/Prior Authorization Coordinator Job Description
Summary: This is a full-time position. This position is eligible for health insurance, paid time off, 401k, etc. This position reports to the Practice Manager as their direct supervisor.
Essential Functions and Responsibilities
  • Managing a patient’s journey from prescription to drug acquisition
  • Navigates the complexities of patient access on behalf of those prescribed biologics
  • Supports doctors, patients and Specialty Pharmacy through a variety of tasks related to patient prescriptions including status and delays
  • Communicates with patients, insurance providers, physicians and other staff as needed
  • Completes enrollment forms and submits prior authorizations for Specialty Medications
  • Reviews benefit verifications and expected costs with patients
  • Writes appeals and letters of medical necessity as needed and/or works with Specialty Pharmacy to complete
  • Directs patient assistance and bridge programs
  • Appropriately interacts with patients, providers, and other staff
  • Responds to patient phone calls and provider tasks in timely manner
  • Full documentation of all communications
  • Coordinates efforts of specialty pharmacies and manufacturer HUBs
  • Completes all other Prior Authorization regarding other medications
  • Organizes, processes and uploads incoming faxes that pertain to biologics and/or prior authorizations
  • Submits refills for biologic medications
  • And other duties/tasks as assigned by management

Qualifications
Required:
  • High school diploma or equivalent
  • Prior experience in a medical office or other healthcare facility
  • Knowledge of biologics and other prescriptions
  • Experience and Knowledge with various health insurances, including Prior Authorizations
  • Knowledge of medical office systems and procedures, EMR
  • Excellent time management skills and ability to multi-task and prioritize work
  • Friendly, team player, excellent collaborator, and communicator
Preferred:
  • Knowledge of NexTech system
  • Knowledge of Biologics process

Physical Demands: significant amount of sitting, screen time, typing, and assisting patients; lifting up to 25 lbs.; occasional bending and stretching
Work environment: Fast-paced office setting. Working independently, but communicating as needed to patients, providers, coworkers, and supervisor.
 

Powered by JazzHR

Xlzdn5fh1j