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Clinic RN/Prior Authorizations

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Location: Pinehurst, North Carolina Facility: 66 - Physician Group Clinics Department: FH CARDIO PINEHURST - 7 REGIONAL DR. 715 Schedule: Full Time: 40 hrs/wk Shift: Day Shift Hours: 8:30-5:00 Job ID: 2024-16523

Overview

FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area’s only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare. 

Employee Benefits

At FirstHealth of the Carolinas, we believe in supporting our employees' professional growth and personal well-being. That is why we offer a comprehensive benefit package that is designed to help you thrive. Enjoy a free gym-membership to one of our 7 FirstHealth Fitness Centers to stay active and prioritize your health, take advantage of our educational assistance programs through FirstU to pursue academic or professional development goals. You'll also benefit from exclusive employee discounts through PerkSpot, saving you money on quality offerings. Additionally, we're committed to your future with a competitive retirement savings plan, including an employer match to help you build financial security. These are just a few examples of how our leading-edge employee benefits align with our mission to put your career first. Join FirstHealth of the Carolinas and help us in our mission to become the best place to work in healthcare!

Obtaining authorizations for procedures and testing performed in office and hospital.

Responsibilities

This position is a full-time job working with prior authorizations and insurances. This role will consist of working with different insurances to obtain prior authorization through insurances to ensure the patient is properly covered. In this position, you will be responsible for working in the work queue for prior authorizations. The work queue will contain requests for various testing such as echocardiograms, nuclear stress testing, stress echocardiograms, ultrasounds, MRI’s, CTs/CTAs, etc. These authorizations must be obtained at least 30days prior to scheduled appointment. This role also includes checking the clinic echocardiogram schedule daily to ensure procedures are authorized. Obtaining authorizations can be done via phone, fax or internet. Training will be given that includes all access to insurance websites. This position will obtain prior authorizations for procedures performed in the hospital by physicians in our clinic such as heart catheterizations, pacemaker/defibrillator implants, ablations, tilt table tests, and more. This position is also responsible for any testing needed for patients with VA/Tricare insurance.  obtaining/requesting VA and tricare referrals. Scanning information into charts. communicating with providers/nurses if any issues arise with authorizations

Qualifications

Required RN, BLS, ACLS and prefer clinic experience and authorization knowledge.

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