2

Full Time Prior Authorization Rn Jobs in Tennessee

AVAILABLE SCHEDULE * Full-Time Day shift (7a-7p) * Full-Time Night shift (7p-7a) * PRN: As needed ... Complete initial pre-authorization for treatment and admission prior to admission, when possible ...

AVAILABLE SCHEDULE * Full-Time Day shift (7a-7p) * Full-Time Night shift (7p-7a) * PRN: As needed ... Complete initial pre-authorization for treatment and admission prior to admission, when possible ...

Office RN

Kingsport, TN · On-site

$27.03 - $40.94/hr

The Office RN is responsible for providing quality, compassionate care to patients in a physician ... Attend nurse meetings and other educational opportunities * "Obtain prior authorizations and pre ...

Office RN

Kingsport, TN

$27.03 - $40.94/hr

The Office RN is responsible for providing quality, compassionate care to patients in a physician ... Attend nurse meetings and other educational opportunities * "Obtain prior authorizations and pre ...

Office RN

Kingsport, TN

$27.03 - $40.94/hr

The Office RN is responsible for providing quality, compassionate care to patients in a physician ... Attend nurse meetings and other educational opportunities * "Obtain prior authorizations and pre ...

Showing results 41-60

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 Tennessee? The most popular types of Prior Authorization Rn jobs in Tennessee are:
What cities in Tennessee are hiring for Full Time Prior Authorization Rn jobs? Cities in Tennessee with the most Full Time Prior Authorization Rn job openings:

Full-time

Medical, Dental, Vision, Retirement

Re-posted 8 days ago


Job description

Overview

We are seeking a dedicated Registered Nurses (RN) to join our Behavioral Health ADMISSIONS team at TrustPoint Hospital in Murfreesboro, TN. Apply now to learn more!

AVAILABLE SCHEDULE

  • Full-Time Day shift (7a-7p)
  • Full-Time Night shift (7p-7a)
  • PRN: As needed

TrustPoint Hospital is a leading behavioral health hospital serving adolescents, adults, and seniors across Middle Tennessee. Our state-of-the-art facility provides inpatient and outpatient psychiatric services in a supportive, patient-centered environment. Conveniently located in Murfreesboro, just 30 minutes from Nashville, TrustPoint offers nurses the opportunity to make a meaningful impact while growing their behavioral health expertise.

As an Admissions RN, you will play a crucial role in ensuring a smooth and efficient admissions process for our patients. Your clinical expertise, attention to detail, and ability to collaborate with various stakeholders will contribute to delivering high-quality care. TrustPoint Hospital is a renowned healthcare facility committed to providing exceptional mental health services to our community and in Intake and Admissions, you can make a real difference in the lives of our patients.

TrustPoint Benefits:

TrustPoint Hospital provides a comprehensive package of benefits for our nurses. Current benefits include:

  • Competitive pay commensurate with experience
  • Referral Bonuses
  • Medical, Dental, and Vision coverage
  • 401(k) plan
  • Continuing education and professional development opportunities
  • Supportive work environment that values teamwork and collaboration
  • Cutting-edge medical facilities and advanced technologies
  • Opportunities for career growth and advancement

PURPOSE STATEMENT:

Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for patients and their benefit/resource utilization.

Responsibilities
  • 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.
  • Communicate projected admissions to designated internal representatives promptly.
  • Ensure all clinical information from referral sources or patients (including medical comorbidity information) is received, when possible, prior to patient admission.
  • Schedule (when applicable) and complete pre-admission assessments, consult with the admitting physician and communicate disposition recommendations to the patient or their family.
  • Possess skill in preparing and maintaining appropriate medical record documentation that will result in authorization at the level of care being requested of the payor.
  • Complete initial pre-authorization for treatment and admission prior to admission, when possible, and within payor timeframe guidelines.
  • Admit the patient to the registration and accounting system. Complete all admission and consent forms with the patient.
  • Demonstrate a positive, empathetic, and professional attitude toward customers always. When patient needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
  • When a patient's needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
  • Coordinate care for patients who are not being admitted and ensure that they receive appropriate follow-up care and referrals.
  • Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service.
  • Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or in accordance with individualized supervision guidelines as needed.

OTHER FUNCTIONS:

  • Perform other functions and tasks as assigned.
Qualifications

EDUCATION/EXPERIENCE/SKILL 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. 

LICENSES/DESIGNATIONS/CERTIFICATIONS: 

  • 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 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

AHRN

#LI-TPH

#LI-KB2

Employment Type: FULL_TIME