Top 13 Prior authorization nurse Jobs in Lancaster, Pa

Authorization Specialist
OSS Health —York, PA
- Monday to Friday
- Hybrid work
- Anatomy knowledge
- Mid-level
- High school diploma or GED
- Profit sharing
- Disability insurance
Licensed Practical Nurse - Family Medicine Chanceford - Full Time
Wellspan Health —Brogue, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse - Digestive Health York - Full Time
Wellspan Health —York, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse - Orthopedic Sports Medicine Lancaster - Full Time
Wellspan Health —Lancaster, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse Outpatient - Meadowbrook Family Med Leola - Days/Evenings
Wellspan Health —Leola, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse - Breast Surgery - Lancaster / Lebanon - Full Time
Wellspan Health —Lebanon, PA
- Full-time
- Nursing
- Surgery
- RN License
- Paid parental leave
- Health insurance
Licensed Practical Nurse
Family First Health —Lebanon, PA
- Full-time
- CPR Certification
- BLS Certification
- HIPAA
- Paid holidays
- Disability insurance
11d
Licensed Practical Nurse-Outpatient
Wellspan Health —Dallastown, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse Outpatient - OBGYN Queen Street York - Days/Evenings
Wellspan Health —York, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Licensed Practical Nurse - Surgical Oncology Apple Hill - Full Time
Wellspan Health —York, PA
- Full-time
- Nursing
- Surgery
- RN License
- Paid parental leave
- Health insurance
Registered Nurse - Rapid Response Deployment Team
Critical Response Strategies, LLC —United States
- Weekends as needed
- Background check
- Spanish
- CPR Certification
Quick Apply

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Authorization Specialist
OSS Health —York, PA
Must have good telephone etiquette, and be able to answer the phones, identify self and direct calls appropriately. SCHEDULE: Monday - Friday 8:00am - 4:30pm.
Customer Service Specialist- Imaging Service Center (Full Time/Day Shift)
Penn Medicine —Lancaster, PA
Supports inbound and outbound calls to or from patients, guests, or appropriate parties to provide services. Refers patient to appropriate person for questions…
Quick Apply
20h

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Infusion Registered Nurse (RN)
IVX Health —Pickerington, OH
Life Support Certifications – BLS certification required; PALS certification preferred. Active and Unrestricted Registered Nurse (RN) license.
Quick Apply
Outpatient Registered Nurse, Neuro Multiple Sclerosis (Riverside)
OhioHealth —Columbus, OH
Current Registered Nurse license from the State of Ohio and/or Current Registered Nurse license in good standing with a multi-state compact state.
11d

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Authorization Specialist

OSS Health -
York, PA

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Job Details

Benefits

Profit sharing
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Anatomy knowledge
Phone communication
Medical insurance coverage verification
High school diploma or GED
ICD-10
Productivity software
Medical terminology
Office phone management

Full Job Description

At OSS Health, our mission is to continually strive to be the healthcare leader in quality, innovation and value. We make every effort to understand and exceed the expectations and needs of our patients. We are committed to providing an environment that is safe, respectful, and dignified at all times.

Joining OSS Health means joining a culture of excellence and teamwork, with a strong focus on employee development and community support. OSS Health offers a great work environment, professional development opportunities, meaningful careers, and competitive compensation.

Are you ready to provide a 5-star “OSSOME” experience? Apply today!

JOB SUMMARY: The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for visits, procedures, surgery, treatment, and testing with the patient’s corresponding insurance company as authorized by the physician. The Authorization Specialist will serve as a liaison between the clinical team, provider, outside facilities and the patient.

SCHEDULE: Monday - Friday 8:00am - 4:30pm

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Screens and analyzes the patient’s medical records for the documentation and criteria required to meet medical necessity for the authorization process.
Obtains patients benefit information from the insurance company.
Familiarizes self with medical policies and criteria for each insurance company.
Follows up in a timely manner with the doctor’s team if additional information is needed.
Reviews clinical documents with Nurse Reviewers and/or Utilization Managers at various insurance companies and third-party administrators.
Coordinates with other OSS department staff, external facility staff and external companies to ensure authorization/referral is obtained.
Communicates with external locations to ensure shipment of injection to OSS.
Ensures authorization is secured with the insurance company prior to scheduled service.
Obtains authorization timely when the service requires an auth prior to scheduling.
Contributes to the development and delivery of team training initiatives.
Communicates with physician’s team to notify patients when unsuccessful at obtaining pre-certification/authorization.
Documents the results of the process in the EMR systems for future reference and for claims processing.
Addresses concerns of insurance companies as well as patients in a professional, calm and understanding fashion.
Maintains an orderly and neat work area.
Maintains confidentiality and always protects sensitive data, including and not limited to patient information.
Maintains performance in alignment with audit standards set by the team/department.
Creates and modifies vendor reports.
Other duties as assigned

EDUCATION:

High School Diploma or equivalent required; Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred.

EXPERIENCE/QUALIFICATIONS:

One-year relevant experience in the medical field or in prior authorization required.
Must have basic knowledge and understanding of CPT/ICD10 codes for insurance verification. Must have basic knowledge and understanding of medications, advanced imaging studies and surgical procedures.
Must have strong clinical knowledge and understanding of medical terminology and anatomy. Orthopedic knowledge is preferred.
Must have proficient computer skills, including Microsoft Office, and skills utilizing basic office equipment.
Must be detail oriented, have excellent organizational and prioritizing skills and be able to meet competing deadlines.
Must possess a high level of analytical skills and critical thinking.
Must be able to work independently. Must be able to demonstrate initiative to provide quality and improve efficiency with an assigned workload.
Must have excellent communication skills, both written and verbal, to ensure communication is accurate.
Must have good telephone etiquette, and be able to answer the phones, identify self and direct calls appropriately.
Must be able to demonstrate flexibility by adapting to new and changing duties to meet patient needs effectively and with efficiency.

BENEFITS INCLUDE:

Competitive Wages

Medical, Dental, Vision available on the first day of employment

Disability, and Life Insurance within 90 days

Company-Paid Group Life Insurance, Short-Term Disability & Long-Term Disability

Paid Time Off (PTO)

401(k) plan and profit sharing

Career Advancement Opportunities

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

prior authorization nurse jobs in lancaster, pa

Authorization Specialist

Licensed Practical Nurse - Family Medicine Chanceford - Full Time

Licensed Practical Nurse - Digestive Health York - Full Time

Licensed Practical Nurse - Orthopedic Sports Medicine Lancaster - Full Time

Licensed Practical Nurse Outpatient - Meadowbrook Family Med Leola - Days/Evenings

Licensed Practical Nurse - Breast Surgery - Lancaster / Lebanon - Full Time

Licensed Practical Nurse

Licensed Practical Nurse-Outpatient

Licensed Practical Nurse Outpatient - OBGYN Queen Street York - Days/Evenings

Licensed Practical Nurse - Surgical Oncology Apple Hill - Full Time

Registered Nurse - Rapid Response Deployment Team

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