Pre-Certification RN- TUHDay Shift
Pre-Certification RN- TUHDay Shift
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1 Vacancy
Job Description
Your Tomorrow is Here!
Temple University Hospital is a nationally respected teaching hospital on Temple Universitys bustling Health Sciences Center campus.The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University the hospital provides a dynamic environment for highquality care teaching and cutting edge research.
Your Tomorrow is Here!
Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH) Fox Chase Cancer Center TUHJeanes Campus TUHEpiscopal Campus TUHNortheastern Campus Temple Physicians Inc. and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.
To support this mission Temple Health is continuously recruiting top talent to join its diverse 10000 strong workforce that fosters a healthy safe and productive environment for its patients visitors students and colleagues alike. At Temple Health your tomorrow is here!
Equal Opportunity Employer/Veterans/Disabled
An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin or protected veteran status and will not be discriminated against on the basis of disability.
Serves as the primary clinical resource in the Precertification Department for the handling of complex authorization issues. Ensures precertification/authorization issues are investigated and handled expeditious and thoughtfully from an administrative technical and clinical perspectives. Serves as the primary liaison between the Precertification Department and staff Physicians in regard to authorization issues. Responsible for reviewing financial/insurance information to determine payer requirements are met by obtaining the appropriate precertification/authorization for payers in order to optimize reimbursement and avoid payment penalties. Bachelors degree in Nursing required within 4 years from date of hire.Education
Bachelors Degree : in Nursing (BSN) or commitment to obtain BSN within 4 years from date of hire (Required)
Other : Graduate of an accredited school of nursing (Required)
Masters Degree (Preferred)
Experience
2 Years recent experience with Utilization Review in a hospital or in insurance company setting (Required)
3 Years experience in clinical acute care (Required)
General Experience in Case Management Utilization Review and transition planning (Preferred)
General Experience in working with utilization review standards (Preferred)
License/Certifications
RNLIC PA Registered Nurse License (Required)
Employment Type
Full-Time
