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RN- Pre-Authorization Nurse (PRN)

Company: KPC Promise Healthcare
Location: Boca Raton
Posted on: May 3, 2021

Job Description:

KPC Promise Heatlhcare: The Pre-Authorization Nurse is responsible for executing the registration functions such as insurance identification, verification and authorization in all areas of pre-admission, inpatient, outpatient services and outpatient surgery, review of admission criteria and admission of patients with medical needs. Using knowledge of LTACH criteria, DRGs, PPS reimbursement, utilization management and HIM coding, this position will maximize clinical data collection in order to support the most appropriate admission MSDRG. Accomplishes the daily operation of all pre-admission activities. This individual is responsible for reviewing documentation for appropriateness of admissions, coordination of all admissions with other departments through the collection, assembly and distribution of appropriate patient information.

QUALIFICATIONS:

1. Registered Nurse or Licensed Practical Nurse, Current, unencumbered Florida License.

2. Two to four years of experience in hospital registration preferred.

3. Working knowledge of the Hospital Admitting Department and/or Business Office procedures.

4. Strong knowledge of Medical Insurance Processes.

5. Must be able to read, write, and speak English, as well as possess good written and oral communication skills

PHYSICAL AND MENTAL REQUIREMENTS:

Physical: Walking – up to 25% Standing – up to 15% Kneeling – up to 5%

Sitting – up to 30% Pushing – up to 5% Bending – up to 5%

Squatting – up to 5% Pulling – up to 5% Reaching - up to 5%

Lifting - up to 25 lbs. Wrist/Finger Movements – up to 90%

Mental: Stress Level: Moderate to high

EXPOSURE RISK: Category III - Jobs in which required tasks involve no greater exposure to blood, body fluids or tissues than would be encountered by a visitor. The normal work routine involves no exposure to blood, body fluids, or tissues.

EQUIPMENT, TOOLS, MATERIALS, MACHINES USED: Computer, telephone, facsimile machine, copier, scanner, printer, calculator and other standard office equipment.

CERTIFICATIONS: None

RATING DEFINITION: (5) Far exceeds expectations (4) Exceeds some

Keywords: KPC Promise Healthcare, Boca Raton , RN- Pre-Authorization Nurse (PRN), Other , Boca Raton, Florida

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