Clinical Authorization Specialist
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Job Location:
Monthly Salary:
Posted on:
19 hours ago
Vacancies:
1 Vacancy
Department:
Job Summary
Overview
If youre looking for a schedule that fits your lifestyle check out PAM Health- andask us about our comprehensive benefits package!
Hours are 11am-8pm CST REMOTE
Some things that our hospital can offer YOU as a full-time employee:
- Medical Benefits: EPO/HDHP/HSAoptions including prescription coverage Rx nGo and Teladoc
- Comprehensivedental and vision benefits
- Employee Assistance Program includingcounseling legal and financial service
- Flexible spending (FSA) and health savings(HSA)accounts
- Life and Disability insurancebenefits
- Education/In-Service Opportunitiesincluding continuing education and tuitionassistance
- Supplemental benefits: Accident critical illness cancer pet and identity theftprotectioninsurance options
- Auto Home Cell Phoneand Gym Membership discountofferings
- Personal Travel Discounts
- Employee Bonus Referral Program
- 401(k) plansand discretionary employer match
- Generous Paid Benefit Time
Responsibilities
The Clinical Authorization Specialist is responsible for managing Commercial and Medicare Advantage admission authorizations by conducting a comprehensive analytic review of clinical documentation to determine if a patient is clinically appropriate for admission and the best course of action to obtain authorization from the payer. The Clinical Authorization Specialist will write sound compelling factual argument for the purpose of admission and/or to overturn a denial received from a payor for admission.
Qualifications
- Education and Training: Bachelors or Associates degree in nursing preferred.
- Knowledge in the area of LTAC and IRF Criteria including: Medicare InterQual and Milliman are preferred.
- Currently licensed as an RN preferred.
- Experience: Five years (5) experience as a clinical nurse in an acute care addition having at least two years of experience in appeals case management discharge planning and/or utilization review is preferred.
About PAM Health
PAM HEALTH (PAM) based in Enola Pennsylvania provides specialty healthcare services through more than 80 locations as well as wound clinics and outpatient physical therapy locations in 17 states. PAM Health is committed to providing high-quality patient care and outstanding customer service coupled with the loyalty and dedication of highly trained staff to be the most trusted source for post-acute services in every community it serves. Its mission is to serve people by providing compassionate expert care and to support recovery through education and research. Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay generous paid benefit time and excellent insurance options you will also have opportunities for professional growth through our Education Advancement Program. We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at for a comprehensive look at how were able to positively impact our local communities.
PAM Health does not discriminate and does not permit discrimination including without limitation bullying abuse or harassment on the basis of actual or perceived race color religion national origin ancestry age gender physical or mental disability sexual orientation gender identity or expression or HIV status or based on association with another person on account of that persons actual or perceived race color religion national origin ancestry age gender physical or mental disability sexual orientation gender identity or expression or HIV status.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
PAM Health is committed to providing patients with the best care and outcomes. We offer both inpatient and outpatient therapy. Find a location near you.
