Revenue Cycle Precertification Nurse- LPN- PRN

This job ensures the financial security of scheduled inpatient and outpatient (excluding ED) accounts for the company's patients by obtaining/initiating prior authorization of ordered services based on payer requirements, after benefits and eligibility have been determined. Coordinates with physician and/or staff for appropriate level of care setting and essential clinical documentation to support medical necessity of services ordered and works collaboratively with Case Management to establish level of care for direct admits and inpatient stays. Also acts as a resource for the Revenue Cycle staff within Pre-Service and performs duties under general supervision and following moderately complex procedures and guidelines.

Education Required - Licensed Practical Nurse (LPN) diploma. Work Experience Required - 3 years of hospital based experience in the delivery of patient care. Job Duties - Secures clinical documentation and performs pre-service medical necessity reviews to obtain prior authorizations.

Maintains professional and technical knowledge and certifications. Ensures all regulatory requirements are met within department. Assists in the day-to-day operations of the department.

Consistently supports the company and its business services goals and core values. Performs other duties as assigned.