Precert RN / LPN

Prestige Staffing • Atlanta, GA, US

20 hours ago

Job type

Permanent

Job description

Pre-certification Nurse (LPN or RN)

Pay : LPN - $3035 RN $40-45 per hour

Location : Sandy Springs, GA

This position is not available for remote work. Located on-site to provide dedicated patient care coordination and authorization support.

Summary

Seeking an experienced Precert RN / LPN to ensure timely insurance approval and clinical clearance for patient treatments. The role involves reviewing precertification requests, initiating authorizations, compiling medical records, and collaborating with healthcare providers to facilitate smooth patient care processes. This vital function supports the organization's commitment to delivering efficient, compliant, and patient-centered care. The position offers a contract duration of three months with the potential for permanent employment based on performance.

Requirements

Valid current Georgia State Medical license
BSN in Nursing or relevant LPN certification
Minimum of 2-3 years of experience in Oncology, Specialty clinics, or Authorization coordination
Knowledge of medical terminology, insurance guidelines, and healthcare protocols
Excellent communication, organizational, and multitasking skills
Proficiency in Microsoft Office and basic computer operations
Ability to work in a fast-paced healthcare environment, maintaining professionalism and confidentiality

Responsibilities

Review incoming drug precertification requests to ensure compliance with insurance, FDA, and NCCN guidelines

Clinically clear chemotherapy and drug requests by verifying patient clinical data beyond diagnostic codes

Coordinate with site nurses to ensure accurate pre-authorizations and correct documentation before submission

Initiate prior authorization requests for high-cost drugs and various procedures using online tools or fax as appropriate

Communicate with physicians and healthcare providers to gather necessary medical records and clarify approval statuses

Track reauthorization needs and compile documentation required for ongoing approvals

Assist with peer-to-peer discussions, attaching relevant policies and medical information

Attend scheduled meetings, training, and process improvement initiatives

Adhere to organization policies, procedures, and service standards

Perform other related duties and cross-training responsibilities as needed

May be required to adapt to COVID-19 safety guidelines and work environment changes

Benefits

Dynamic team environment with growth potential

Opportunity to develop specialized skills in oncology and healthcare authorization

Supportive work culture focused on excellence and professionalism

Potential for permanent employment based on performance and organizational needs

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Precert • Atlanta, GA, US