Clinical Nursing, IP (Internet Protocol), Nursing, Nursing Credentials, Team Lead/Manager
SHIFT: Monday- Friday 8am-5pm EST, OT not required
Duration: 3 months, possible to extend or convert
Description: - Process authorization requests for TP product
- Team leader creates the assignment and sends to the team daily- Team members are expected to complete nurse reviews on the assigned cases. Ones not meeting clinical criteria will need to be sent to the medical director for second level review
- Remote; Has the ability to review both PA and IP requests.
- Must possess at least 2 years of prior Prior Authorization experience.
Candidate Requirements Education/Certification Required: Graduate from an Accredited School of Nursing or Bachelors degree in Nursing and 2 4 years of related experience. Preferred: Licensure Required: LPN - Licensed Practical Nurse - State Licensure required / Compact License Preferred: RN - Years of experience required
- Disqualifiers
- Best vs. average
- Performance indicators
Must haves: 2 years experience with PA auth reviews
Nice to haves: Previous experience with NC State Criteria/ InterQual Criteria
Disqualifiers:
Performance indicators: 15 Auths reviews per day - Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
1 Must have 2 years prior exp in PA or IP with an insurance company 2 Must be a team player 3 Must be willing to work an alt schedule of Monday - FridayA
Axelon Services Corporation