Precert RN/LPN

Pre-certification Nurse (LPN or RN)

Pay:  LPN - $3035  RN $40-45 per hour

Location:  Sandy Springs, GA

This position is not available for remote work. Located on-site to provide dedicated patient care coordination and authorization support.

Summary:

Seeking an experienced Precert RN/LPN to ensure timely insurance approval and clinical clearance for patient treatments. The role involves reviewing precertification requests, initiating authorizations, compiling medical records, and collaborating with healthcare providers to facilitate smooth patient care processes. This vital function supports the organization's commitment to delivering efficient, compliant, and patient-centered care. The position offers a contract duration of three months with the potential for permanent employment based on performance.

Requirements

• Valid current Georgia State Medical license
• BSN in Nursing or relevant LPN certification
• Minimum of 2-3 years of experience in Oncology, Specialty clinics, or Authorization coordination
• Knowledge of medical terminology, insurance guidelines, and healthcare protocols
• Excellent communication, organizational, and multitasking skills
• Proficiency in Microsoft Office and basic computer operations
• Ability to work in a fast-paced healthcare environment, maintaining professionalism and confidentiality

Responsibilities

• Review incoming drug precertification requests to ensure compliance with insurance, FDA, and NCCN guidelines
• Clinically clear chemotherapy and drug requests by verifying patient clinical data beyond diagnostic codes
• Coordinate with site nurses to ensure accurate pre-authorizations and correct documentation before submission
• Initiate prior authorization requests for high-cost drugs and various procedures using online tools or fax as appropriate
• Communicate with physicians and healthcare providers to gather necessary medical records and clarify approval statuses
• Track reauthorization needs and compile documentation required for ongoing approvals
• Assist with peer-to-peer discussions, attaching relevant policies and medical information
• Attend scheduled meetings, training, and process improvement initiatives
• Adhere to organization policies, procedures, and service standards
• Perform other related duties and cross-training responsibilities as needed
• May be required to adapt to COVID-19 safety guidelines and work environment changes

Benefits

• Competitive hourly pay with opportunities for overtime
• Dynamic team environment with growth potential
• Opportunity to develop specialized skills in oncology and healthcare authorization
• Supportive work culture focused on excellence and professionalism
• Potential for permanent employment based on performance and organizational needs