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RN – Registered Nurse, Clinical Access Specialist
Location
Pennsylvania
Posted
2 days ago
Salary
0
Seniority
Senior
Job Description
RN – Registered Nurse, Clinical Access Specialist
Geisinger
• performs utilization review, medical necessity assessments, and authorization activities to promote quality outcomes, timely reimbursement, and effective care transitions • reviewing clinical documentation, verifying coverage and certification requirements • collaborating with physicians and care teams • maintaining accurate utilization review records, supporting documentation integrity, and ensuring compliance with state, federal, and third-party payer standards • identifying and notifying appropriate staff regarding discrepancy issues with third party payer health insurance coverage and lack of coverage
Job Requirements
- At least three (3) years of RN work experience is required
- Previous experience in an acute care setting is highly preferred
- Previous Utilization Management experience is highly preferred
- BSN is preferred
- Graduate from Specialty Training Program-Nursing (Required)
- Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
Benefits
- healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners
- encourages an atmosphere of collaboration, cooperation and collegiality.
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