Tennessee Licensed Prior Authorization Specialist

A company is looking for a Prior Authorization Specialist / Payor Relations Specialist (RN or LPN).

Key Responsibilities

Manage pre-certification and prior authorization of patient referrals for hospital admission

Communicate with payors to obtain timely authorizations and ensure compliance with policies

Collaborate with Business Development and Case Management to facilitate patient care continuity

Required Qualifications

Must be a Registered Nurse (RN) or Licensed Practical Nurse (LPN)

At least two (2) years of direct experience in third party reimbursement

Experience working with Excel and databases is preferred