Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Mobile MAT Licensed Practical Nurse (51007)
Miami, FL · On-site
$24.03/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Mobile MAT Licensed Practical Nurse (51007)
Miami, FL · On-site
$24.03/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Registered Nurse (51021)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51021)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Mobile MAT Licensed Practical Nurse (51007)
$24.75 - $33.50/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Mobile MAT Licensed Practical Nurse (51007)
$24.75 - $33.50/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Registered Nurse (51021)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51021)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Mobile MAT Licensed Practical Nurse (51007)
Miami, FL · On-site
$24.03/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Mobile MAT Licensed Practical Nurse (51007)
Miami, FL · On-site
$24.03/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures * Makes rounds to assess patient needs, unit safety ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
Marathon, FL · On-site
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51021)
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51021)
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Registered Nurse (51256)
$37.45/hr
Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time * Makes daily rounds at least twice ...
Busy Hematology / oncology practice seeking a self motivated, hard working, detail oriented person for the PreCertification/Authorization of chemotherapy medicines includes: Obtaining pre ...
Busy Hematology / oncology practice seeking a self motivated, hard working, detail oriented person for the PreCertification/Authorization of chemotherapy medicines includes: Obtaining pre ...
Medical Director
Miami, FL · On-site
Precertification, Case Management and Medical Audit to ensure the development of a solid and scalable operational platform with the objectives of ensuring our members receive optimal medical care ...
Medical Director
Miami, FL · On-site
Precertification, Case Management and Medical Audit to ensure the development of a solid and scalable operational platform with the objectives of ensuring our members receive optimal medical care ...
Handles portal messages from patients, refill medications, order additional labs or imaging as needed, complete prior authorizations, complete precertification for imaging, etc. * Maintains ...
Handles portal messages from patients, refill medications, order additional labs or imaging as needed, complete prior authorizations, complete precertification for imaging, etc. * Maintains ...
Surgery Coordinator - Orthopedics
Naples, FL · On-site
$27/hr
This position does not require getting insurance authorizations since we have a full time precertification coordinator.Duties: Schedule surgical procedures ensuring efficient use of operating room ...
Surgery Coordinator - Orthopedics
Naples, FL · On-site
$27/hr
This position does not require getting insurance authorizations since we have a full time precertification coordinator.Duties: Schedule surgical procedures ensuring efficient use of operating room ...
Utilization Management Representative I (US)
Miami, FL · On-site
$35K - $41K/yr
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact : * Managing incoming calls or ...
Utilization Management Representative I (US)
Miami, FL · On-site
$35K - $41K/yr
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact : * Managing incoming calls or ...
Utilization Management Representative II
Miami, FL · On-site
$16.25 - $19.25/hr
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. * Obtains intake (demographic ...
Utilization Management Representative II
Miami, FL · On-site
$16.25 - $19.25/hr
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. * Obtains intake (demographic ...
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. * Obtains intake (demographic ...
Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. * Obtains intake (demographic ...
Precertification information
See Florida salary details
$3.95 - $5.67
0% of jobs
$5.67 - $7.38
7% of jobs
$7.38 - $9.10
5% of jobs
$9.10 - $10.81
0% of jobs
$11.22 is the 25th percentile. Wages below this are outliers.
$10.81 - $12.53
53% of jobs
$13.78 is the 75th percentile. Wages above this are outliers.
$12.53 - $14.24
13% of jobs
$14.24 - $15.96
0% of jobs
$15.96 - $17.67
0% of jobs
$17.67 - $19.38
1% of jobs
$19.38 - $21.10
6% of jobs
$21.10 - $22.81
14% of jobs
$3
$14
$22
How much do precertification jobs pay per hour?
What are precertification jobs?
What are some common challenges faced by Precertification Specialists, and how can they be addressed?
What are the key skills and qualifications needed to thrive in a precertification specialist role, and why are they important?
What is the difference between Precertification vs Medical Coder?
| Aspect | Precertification | Medical Coder |
|---|---|---|
| Required credentials | Certification may be preferred; knowledge of insurance policies | Certification (e.g., CPC, CCS) often required |
| Work environment | Healthcare facilities, insurance companies, outpatient clinics | Hospitals, clinics, insurance companies, remote work |
| Employer usage | Used to approve procedures before service | Used to assign codes for billing and documentation |
| Common search intent | Precertification vs Medical Coder |
Precertification involves obtaining approval from insurance companies before procedures, focusing on insurance policies and patient eligibility. Medical coders assign standardized codes to medical records for billing, emphasizing coding accuracy and documentation. While both roles are integral to healthcare billing, precertification is about approval processes, whereas medical coding centers on documentation and coding accuracy.

Job description
https://info.flclearinghouse.com
Position Summary:
Person in this position will be responsible for providing professional nursing care to clients who are voluntarily and involuntarily admitted to the crisis stabilization and detoxification units of the clinic.
Essential Job Functions:
- Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time
- Makes daily rounds at least twice every shift to assess patient needs, unit safety, and reports any unsafe conditions or compromised quality of care to Lead Registered Nurse
- Continually assesses patients' medication needs; focusing on detoxification, PRN psychotropic, side effects and documenting such findings in progress notes per policies and procedures 100% of the time
- Assesses client in seclusion and restraints per policy and procedure at required intervals 100% of the time
- Completes nursing assessment, initial treatment plan (including any nursing/medical problems) and the Individual Treatment Plan to establish treatment needs according to the standards of care 100% of the time
- Completes nursing assessment for every assigned client including Mental Status Exam on all new admissions
- Demonstrates the ability to identify and evaluate an individual's strengths, barriers, problems, and needs for the development of Preliminary/Initial Wellness and Recovery Plan
- Initiates assessment of patient needs and provides appropriate treatment/medical care utilizing MD when appropriate 100% of the time
- Initiates emergency screening protocol and decides when to consult on-call staff in accordance with on-call procedures
- Participates in report between shifts highlighting client behavior, medical condition, medication status and client census 100% of the time
- Meets at least once per shift with designated behavioral health technician to coordinate client activities and deploy appropriate staff 90% of the time
- Participates in Treatment Team and the development or revision of patient Individual Treatment Plan (day shift)
- Participates in familiarizing self with treatment plans/case reviews and implementing all features (evening and night shifts)
- Provides 1x1 counseling and other direct care for patients every shift per treatment plan and policies and procedures
- Responds promptly per treatment plan and policies and procedures to inappropriate, withdrawn, agitated, or vegetative client behavior 100% of the time
- Applies TACT techniques properly and effectively 100% of the time in response to client aggression
- Facilitates scheduled therapeutic and educational groups at least once per week
- Participates in staff meetings, client conferences, and treatment teams to coordinate management of medical and nursing client care at least weekly or as assigned by Unit Director
- Communicates pertinent client information to medical staff, unit coordinator, and other disciplines when appropriate,100 % of the time
- Responds to client questions and requests in a timely fashion 90% of the time
- Implements behavior modification plans as required 100% of the time
- Provides nursing interventions appropriate to patient medical and psychosocial needs, i.e., health education, STD, HIV, First Aid, DM, injury, other chronic or acute illness per individualized treatment plan and nursing assessment
- Reviews MD's orders and documents as per policy and procedure 100% of the time
- Assumes role of charge nurse as assigned, per P &P, 100% of the time
- Documents the following on all patients; patient insurance status and precertification, patient admission assessment, insurance identifying problems, established priorities for treatment and care, initial treatment plan for each client, Transcription o medication orders, discharge summary, progress note per policy and procedure manual 100% of the time
- Inventories controlled drugs at the beginning and end of each shift and report any discrepancies 100% of the time
- Assures that informed consents for medication for each client are signed and in chart prior to administering medication 100% of the time
- Administers medication without error to unit clients per policy and procedure 100% of the time
- Administers PRN and OTC medications per physician orders, documents and observes effects
- Participates in discharge plan for all assigned clients as part of multidisciplinary team (including client's family) and documents discharge summary as per policy and procedure
- Reviews and evaluates effectiveness of interventions and implementation of nursing care
- Applies knowledge of the inter-relationship among substance abuse disorders, mental health disorders, and chronic medical conditions
- Demonstrates the ability to evaluate the impact of substance use, mental health problems, and chronic medical conditions on the client's functioning in major life areas
- Documents and reports client outcomes and responses resulting from nursing interventions, treatment procedures, interpersonal interactions, and patient/family education 100% of the time
- Evaluates and documents client progress towards goals and objectives every shift
- Updates and revises patient care problem list and individualized client care standards based on client and family responses, progress toward goals, and/or change in medical and mental status every shift
- Evaluates client length of stay and related transfer and discharge planning needs based on anticipated problems and needs, internal or community resources and support systems for all assigned clients
- Evaluates progress of other RNs, BHT's, student's or staff persons being oriented as assigned
- Acts as a role model and resource person for colleagues
- Participates in required staff development / training activities.
- Maintains up-to-date knowledge of clinical area of practice. Participate in trainings on trauma informed care, assessing and treating victims of domestic violence, trauma-focused cognitive behavioral therapy, motivational interviewing and Seeking Safety
- Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position.
- Demonstrates a high degree of dependability.
- Maintains a good attendance record.
- Observes working hours.
- Exhibits characteristics of good workmanship, and integrity on the job.
- Work time is always productive.
- Establishes and maintains effective and positive working relationships with clients, co-workers, and other job-related representatives.
- Readily develops and maintains therapeutic relationships with clients.
- Effectively interacts with client's family and significant others.
- Shows flexibility and is responsive to requests from supervisor.
- Works independently with minimal supervision.
- Is courteous to clients, staff, and all others.
- Cooperates with others both within and outside the Guidance/Care Center.
- Demonstrates tact at the appropriate time.
- Works well with supervisor; accepts direction and supervision.
- Maintains a positive attitude toward work.
- Ensures and maintains a safe working environment.
- Work area is clean and orderly.
- Verbalizes, understands and adheres to Center safety procedures.
- Demonstrates appropriate use of Unusual Incident Reports, in accordance with the Center's reporting procedures.
- Presents a positive personal image.
- Dresses and maintains a professional demeanor
- Performs other duties as requested.
- Miscellaneous duties are performed according to instruction.
Certifications/Licensures:
- Must hold valid Registered Nurse or ARNP License in the state of Florida in good standing.
- Graduation from an accredited four-year college with a Bachelors of Science in Nursing field is preferred;
- Associate of Science in Nursing from an accredited college is required.
- Two (2) years of experience in providing nursing care to target population is preferred;
- Proficient in performing nursing physical assessment and mental status exams
- During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.
- CPR Certification, First Aid Certification and an annual Tuberculosis test.
- Ability to provide an Affidavit of Good Moral Character
- Ability to meet GCC insurance requirements for driving an agency vehicle
- Clearance in Pre-Employment Drug Testing and Criminal Records Checks, as required.
- Possesses sufficient means of independent mobility.
- Excellent communication skills;
- Demonstrates the ability to use DSM V diagnostic criteria to provide substance use, mental health, and behavioral diagnoses
- Demonstrated knowledge of theoretical and practical concepts of individual, group and family behavior
- Demonstrated ability to deal with crisis situations
- Knowledge to deal with difficult people
- Demonstrated ability to handle a client concern/grievance according to agency protocol.
- Demonstrated ability to establish and maintain effective working relationships with clients, co-workers, external partners, and regulatory agencies
- Demonstrated ability to manage change and achieve results
- Demonstrated ability to expedite a voluminous flow of detailed work
- Demonstrated ability to prepare clear and precise reports
- Demonstrated ability to follow and interpret instructions
- Demonstrated ability to appropriately and efficiently identify, prioritize and follow through on assignments
- Maintains confidential files and records
- Working knowledge of behavioral health terminology
- Knowledge of WestCare Mission, goals and values
- Knowledge of Incident Reporting
- Knowledge of HIPAA, Professional Ethics, Consumer Rights and Confidentiality
- Familiarity with WestCare services and programs
- Understands that different cultural and ethnic groups have different perceptions of health, wellness, behavioral health, and preventive health services
- Ability to use trauma informed care principles including ensuring consumer safety, preventing/avoiding re-traumatization, maximizing trustworthiness, enhancing consumer choice, maximizing collaboration, and emphasizing empowerment
- Ability to identify and describe key signs, symptoms, impact and manifestations of trauma
- Aware of the differences between trauma informed and trauma-specific services
- Understands the bidirectional relationships among substance use and mental disorders and trauma
- Ability to read, analyze, and interpret agency and grant required documents
- Ability to respond effectively to the most sensitive inquiries or complaints
- Ability to collect data, establish facts, and draw valid conclusions.
- Understands, communicates (both verbally and in writing), and collaborates effectively and with precision, given the time constraints of each task.
- Understands the differences among various kinds of abuse and trauma, including: physical, emotional, and sexual abuse; domestic violence; experiences of war for both combat veterans and survivors of war; natural disasters; and community violence
- Work is primarily performed in a health care setting
- Some outdoor activities may be required.
- Personal Protective Equipment
- Gloves are worn when cleaning.
- Gloves are worn when using housekeeping and floor care products
- Eye goggles are worn when pouring housekeeping and floor product
- Gloves, mask, gown, eye goggles are used for Code Strong as required for the situation
- Appropriate PPE will be worn as required by any chemical or exposure situation
- Level of access to PHI -
- Full access to entire client record, assigned clients; Limited access to records in stored areas - access to outpatient record area, access to inpatient record area records, access to Growth Center record area or a combination of 2 areas. Limited access to computer options as defined by supervisor on the MIS Authorization Sheet
The employee must be able to perform the following essential duties and activities with or
without accommodation:
Physical Demands:
- Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 50 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations through the use of approved physical de-escalation techniques.
- Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
- Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.
- Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee's essential job functions and to observe client behavior and activities in and out of the facility.
- The normal work routine involves exposure to human blood, body...