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Full Time Prior Authorization Rn Jobs in Florida

Premise Health

Registered Nurse, RN

Kissimmee, FL · On-site

As a Full Time Registered Nurse , you'll provide care to client employees in our Health Center ... Great benefits package with generous PTO What You'll Do • Review and process prior authorization ...

USHP

Registered Nurse- Cardiology

Stuart, FL · On-site

Florida Cardiovascular Partners Registered Nurse- Cardiology Full Time, Monday-Friday, 5x8 schedule ... Manage medication refill workflows, prescription routing, and prior authorization support for ...

USHP

Registered Nurse- Cardiology

Jupiter, FL · On-site

Florida Cardiovascular Partners Registered Nurse- Cardiology Full Time, Monday-Friday, 5x8 schedule ... Manage medication refill workflows, prescription routing, and prior authorization support for ...

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Full Time Prior Authorization Rn information

What are Full Time Prior Authorization RNs?

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.
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
Registered Nurse, RN

Registered Nurse, RN

Premise Health

Kissimmee, FL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 18 days ago

Premise Health rating

8.0

Company rating: 8.0 out of 10

Based on 43 frontline employees who took The Breakroom Quiz

88th of 885 rated healthcare providers

Job description

Premise's mission is to help people get, stay, and be well. We hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com.
As a Full Time Registered Nurse, you'll provide care to client employees in our Health Center located in Lake Buena Vista, FL.
Job Highlights
  • Collaborative, fun, and supportive team culture focused on exceptional patient care
  • Full-time role with comprehensive benefits and a schedule that supports work-life balance
  • Monday through Friday: 8:00am-4:30pm
  • Great benefits package with generous PTO

What You'll Do
• Review and process prior authorization requests accurately and efficiently
• Ensure all clinical documentation is complete and submitted appropriately
• Follow up on pending authorization determinations and status updates
• Review discharge reports and identify patients needing transition-of-care support
• Conduct post-discharge outreach calls to patients
• Address patient questions, concerns, and care coordination needs
• Coordinate and schedule follow-up appointments with providers as needed
• Collaborate closely with providers and interdisciplinary care teams to ensure continuity of care
• Identify and help resolve gaps in care and communication barriers
• Maintain timely and accurate EMR documentation
• Manage a high volume of tasks and patient coordination activities in a fast-paced environment
• Support efficient communication between patients, providers, and care team members in a non-patient-facing role
What You'll Bring
  • Certificate from an accredited Nursing School or associate degree (A.S.) is required; Bachelor's degree (BSN) from four-year college or university is preferred
  • Currently licensed Registered Nurse in state of practice required
  • Current certification with hands-on training in AHA, ARC or equivalent Basic Life Support for health care providers is required; Advanced Cardiac Life Support may also be required based on contract scope of services
  • At least three years of experience as a Registered Nurse in an emergency room, occupational health clinic or other ambulatory care clinic

Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers full-time team members benefits including medical, dental, vision, life and disability insurance, a 401(k) program with company match, paid holidays and vacation time, a company-sponsored wellness program, EAP, access to virtual primary care and virtual behavioral health at no cost for team members and their dependents. Additional benefits can be viewed here: https://jobs.premisehealth.com/benefits.
Premise is an equal opportunity employer; we value inclusion and do not discriminate based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including pregnancy and related conditions), gender identity or expression, sexual orientation, age, physical or mental disability, genetic information, past, current or prospective service in the uniformed services, or any other characteristic protected under applicable federal, state, or local law.
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About Premise Health

Sourced by ZipRecruiter

Premise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care - in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions. Premise delivers value by simplifying complexity and breaking down barriers to give diverse member populations access to convenient, integrated, high-quality care. We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Brentwood, TN, US

Year founded

1975

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