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Manager Prior Authorization Rn Jobs in Tennessee

StatCare, LLC

Prior Authorization Coordinator

Knoxville, TN · On-site

$15.25 - $19/hr

StatCare strives to work collaboratively with hospital partners, nurses, and support staff ... Prior Authorization Coordinator is responsible for securing prior authorizations for diagnostic ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...

CivicMinds, Inc.

Registered Nurse

Murfreesboro, TN · On-site

Registered Nurse Location:- Richmond, VA Job Type:- Full-time Responsibilities will Include ... Intake/Prior Authorization team, our Purchasing Team, Home Infusion/Specialty Pharmacy team, and ...

IVX Health

PRN Registered Nurse (RN)

Jackson, TN

Support Operations and Training - Assist in inventory management, prior authorizations, and ... Active and Unrestricted Registered Nurse (RN) license * Life Support Certifications - BLS ...

OneOncology

Sr. Manager, Authorizations

Nashville, TN · On-site

Complete management of the prior authorization team * Hire new team members as necessary and manage the performance of all existing team members * Create and maintain a staffing model that adequately ...

IVX Health

PRN Registered Nurse (RN)

Jackson, TN

As a Registered Nurse at IVX Health, you'll be at the forefront of delivering personalized ... Support Operations and Training - Assist in inventory management, prior authorizations, and ...

IVX Health

PRN Registered Nurse (RN)

Jackson, TN · On-site

As a Registered Nurse at IVX Health, you'll be at the forefront of delivering personalized ... Support Operations and Training - Assist in inventory management, prior authorizations, and ...

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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 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 Manager Prior Authorization Rn jobs?

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

Manager Prior Authorization Rn jobs near you

Prior Authorization Coordinator

StatCare, LLC

Knoxville, TN • On-site

$15.25 - $19/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 27 days ago

Job description

Description
StatCare is a private Pulmonary, Critical Care, Sleep, and Hospitalist medical practice dedicated to providing high-quality inpatient & outpatient care to patients throughout East Tennessee. Our physicians and advanced practice providers are committed to delivering patient-centered care to ensuring continuity, expertise, and compassion at every stage of hospitalization. StatCare strives to work collaboratively with hospital partners, nurses, and support staff, improving health outcomes and elevate the standard of care for the communities we are proud to serve.
Prior Authorization Coordinator is responsible for securing prior authorizations for diagnostic testing, including but not limited to CT scans, MRIs, and other procedures, ensuring patients receive timely access to care while minimizing delays in treatment. The ideal candidate will work closely with providers, patients, insurance companies, and diagnostic facilities to ensure all authorizations are obtained accurately and efficiently.
Examples of Duties: (List does not include all duties assigned)
  • Obtain prior authorizations for diagnostic testing (CT scans, MRIs, etc.) and pulmonary-related procedures.
  • Verify insurance coverage and requirements before submitting authorization requests.
  • Communicate with insurance companies, providers, and diagnostic centers to facilitate approvals.
  • Track and follow up on pending authorizations to ensure timely completion.
  • Document all authorization activities in the patient's medical record and maintain accurate records.
  • Notify providers and patients promptly of authorization status, including denials and next steps.
  • Collaborate with clinical and administrative staff to prevent delays in patient care.
  • Assist with appeals or re-submissions when necessary.
  • Maintain confidentiality and compliance with HIPAA and all applicable regulations.

KNOWLEDGE, SKILLS, AND ABILITIES
  • Minimum of 1-2 years of prior authorization, insurance verification, or medical office experience (pulmonary or specialty office experience preferred).
  • Knowledge of insurance guidelines, medical terminology, and diagnostic testing procedures.
  • Proficiency with electronic health records (EHR) and Microsoft Office Suite.
  • Excellent communication and customer service skills.
  • Ability to work independently and as part of a team in a fast-paced environment and multi-task.
  • Ability to apply policies and principles to solve everyday problems and deal with a variety of situations.
  • Ability to work effectively with physicians, patients, staff and the public.
  • Ability to establish priorities and coordinate work activities.

Educaton: High School Diploma or GED required.
WORK LOCATION: In-Person, Full-Time, Monday - Friday
BENEFITS:
  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

StatCare symbolizes excellence, every patient, every time. Our success is built on a strong foundation of high-quality patient-centered care, physician ownership, collaborative relationships, and entrepreneurial spirit. We foster a culture rooted in professionalism, trust, and communication - values that extend across our internal teams and our external relationships with healthcare partners.

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