Job Title: Prior Authorization LPN/RNLocation: Johnson County Hospital, Tecumseh, NEDepartment: NursingReports To: DON Position Summary: The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers.Duties & Responsibilities: Review chart documentation to ensure patients meet medical policy guidelinesPrioritize incoming authorization requests according to urgencyObtain authorization via payer website or by phone and follow up regularly on pending casesMaintain individual payer files to include up to date requirements needed to successfully obtain authorizationsInitiate appeals for denied authorizationsRespond to clinic questions regarding payer medical policy guidelinesConfirm accuracy of CPT and ICD-10 diagnoses in the procedure orderContact patients to discuss authorization statusWorks with patients regarding insurance eligibility and pricing estimates for front end collections for medical servicesOther duties as assignedQualifications & Skills: Knowledge of procedure authorization and its direct impact on the practice's revenue cycleUnderstanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectivelyBasic understanding of human anatomy, specifically musculoskeletalProficient use of CPT and ICD-10 codesExcellent computer skills including Excel, Word, and Internet useDetail oriented with above average organizational skillsPlans and prioritizes to meet deadlinesExcellent customer service skills; communicates clearly and effectivelyAbility to multitask and remain focused while managing a high-volume, time-sensitive workloadLPN or RN license in the State of Nebraska2 years medical prior authorization experience preferred2 years experience in a medical related field required Benefits We Offer: Competitive wagesComprehensive health, dental, and vision insuranceRetirement savings planProfessional development opportunitiesSupportive and collaborative work environmentPaid time offSick payWhy Join Us?At Johnson County Hospital, we value our team and foster a supportive environment where you can thrive. Join us to make a difference in the lives of our patients and their families.