Pre-Service Nurse Coordinator - PRN

Job description

Employment Type: Part time Shift: Description: Job Title: Clinical Pre-Service Nurse Coordinator Employment Type: Pool / PRN: Shift: Mixed/Varied, 8 hour shifts: Position Purpose: The Clinical Pre-Service Nurse Coordinator is directly responsible for reviewing pre/post service initial denials, securing escalated insurance authorizations, handling escalated medical necessity reviews and coordinating with Patient Access, Mid-Revenue Cycle and Patient Business Service (PBS) to identify opportunities for revenue optimization. This role is supporting the Mid-Atlantic Region which includes: Saint Francis Hospital, Wilmington, DE Mercy Fitzgerald Hospital, Darby, PA: Nazareth Hospital, Philadelphia, PA: St. Mary Medical Center, Langhorne, PA As a Clinical Pre-Service Nurse Coordinator you will: Works closely with Physician Providers to assure that the proposed intensity of service is in alignment with the severity of illness and accurately documented to support level of care determinations and required authorizations. Investigates denials and root causes and tracks and reports trends to remediate issues and assist with internal process improvement. Leverages clinical knowledge and standar...