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Manager Prior Authorization Rn Jobs in Iowa (NOW HIRING)

LPN or RN - Rheumatology

Dubuque, IA · On-site

$25.75 - $35/hr

Coordinate and manage prior authorization requests for medications and procedures. Work closely ... Valid LPN/RN Licensure with the ability to practice in Iowa. Interpersonal Skills - A significant ...

LPN or RN - Rheumatology

Dubuque, IA · On-site

$25.75 - $35/hr

Coordinate and manage prior authorization requests for medications and procedures. Work closely ... Valid LPN/RN Licensure with the ability to practice in Iowa. Interpersonal Skills - A significant ...

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Manager Prior Authorization Rn information

What is the difference between Manager Prior Authorization Rn vs Nurse Case Manager?

AspectManager Prior Authorization RnNurse Case Manager
CredentialsRN license, certifications in prior authorizationRN license, case management certification
Work EnvironmentUtilization review, insurance companies, healthcare administrationPatient advocacy, care coordination, healthcare facilities
Employer & IndustryInsurance companies, healthcare organizationsHospitals, clinics, insurance providers

The Manager Prior Authorization Rn primarily focuses on reviewing and approving insurance claims for medical procedures, ensuring compliance with policies. Nurse Case Managers coordinate patient care, advocate for patients, and manage treatment plans. While both roles require RN licensure and healthcare knowledge, the Manager Prior Authorization Rn emphasizes administrative review, whereas Nurse Case Managers are more involved in direct patient care coordination.

Is manager prior authorization RN a stressful job?

Manager Prior Authorization RNs often experience stress due to managing complex approval processes, strict deadlines, and high caseloads. The role requires strong organizational skills and attention to detail, which can contribute to job pressure, especially in fast-paced healthcare environments.

What cities in Iowa are hiring for Manager Prior Authorization Rn jobs?

Cities in Iowa with the most Manager Prior Authorization Rn job openings:

Authorization Coordinator | Oncology Care Specialist

Selma, IA • On-site

MLee Healthcare Staffing and Recruiting, Inc
Health Care and Social Assistance • 51 - 200 employees

$16.75 - $20.75/hr

Other

Posted yesterday

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Job description

Authorization Coordinator | Oncology Care Specialist

We are seeking a dedicated Authorization Coordinator specializing in oncology care to join a healthcare team serving the Midwest region. This role focuses on verifying prior authorizations, ensuring all outpatient orders meet medical necessity requirements, and maintaining accurate authorization records within the electronic health record system.

Key Responsibilities
  • Verify if prior authorizations are required and confirm authorization numbers are documented correctly.
  • Review all orders for completeness and accuracy, obtaining missing information as needed.
  • Send verification requests for providers not currently in the system, confirming licensure, National Provider Identifier (NPI), and contact details.
  • Run Medicare orders through compliance software to validate medical necessity and follow up with providers for additional documentation when necessary.
  • Obtain and ensure prior authorizations are approved before scheduling tests.
  • Communicate with patients regarding Advanced Beneficiary Notifications (ABN) when required.
  • Monitor daily schedules to confirm all orders and authorizations are in place prior to patient appointments.
  • Manage EPIC work queues and stay current with patient account policies to assist patients and staff effectively.
  • Collaborate with healthcare providers and insurance companies to resolve authorization issues and maintain accurate records of requests and outcomes.
  • Educate patients about coverage options and the prior authorization process.
  • Adapt to a fast-paced, dynamic environment while prioritizing tasks and fostering a servant leadership approach.
  • Maintain confidentiality and meet physical demands of the role with or without accommodations.
Education and Certification
  • Graduate of an accredited nursing program with current licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN) eligible to work in the region.
  • Current AAPC or RHIT certification is required.
Experience and Skills
  • Proven experience in healthcare settings, preferably in prior authorization or medical billing.
  • Strong knowledge of ICD-10-CM, HCPCS, CPT-4 coding, medical terminology, anatomy, and physiology.
  • Familiarity with insurance policies and prior authorization procedures.
  • Excellent verbal and written communication skills for effective interaction with providers, patients, and insurance representatives.
  • Ability to analyze information and make decisions based on policies and regulations.
  • Completion or willingness to complete Mandatory Reporter training within six months of hire.
  • Commitment to compliance programs and ongoing education as required.