PA Licensed Precertification RN
VirtualVocationsBirmingham, Alabama, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Precertification RN.
Key Responsibilities
Evaluate healthcare service requests and apply clinical criteria to determine medical necessity
Collaborate with providers to clarify clinical details and ensure compliance with guidelines
Confirm service coverage, maintain documentation, and monitor utilization trends
Required Qualifications
Must reside in Pennsylvania, New Jersey, or Delaware
Active PA RN or LPN license (Compact licenses not accepted)
Minimum 2 years of acute care experience in a hospital or healthcare setting
Clinical background in orthopedic unit, outpatient ambulatory surgery center, or surgical unit
Prior experience in medical management, precertification, or prior authorization
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Precertification • Birmingham, Alabama, United States
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