Prior Authorization Specialist-LPN Position Available In Catoosa, Georgia

Prior Authorization Specialist-LPN Phoenix Cardiovascular Institute 4616 Battlefield Pkwy, Ringgold, GA 30736 Join a dedicated cardiovascular healthcare team that provides supportive leadership to employees to ensure exceptional patient care. The Licensed Practical Nurse (LPN Cardiology Device Nurse) offers professional nursing knowledge, skills, and abilities in the provision and management of care to patients at the Phoenix Cardiovascular Institute through the application of the nursing and device management processes. Demonstrates exceptional technical knowledge of cardiology devices and uses reports to help manage care with the healthcare team.

Specific Duties:

Investigate insurance eligibility and benefits for hospital-based interventional procedures Collect and review required clinical documentation to support authorization requests Initiate and follow up on prior authorization requests with insurance companies. Monitor pending authorizations and take proactive steps to reduce turnaround times. Communicate authorization outcomes to providers, patients, and internal teams in a timely manner, and accurately input and update authorization details in eClinicalWorks. Appeal denied authorizations when appropriate, including gathering additional documentation or coordinating peer-to-peer reviews. Maintain up-to-date knowledge of payer-specific guidelines and policy changes. Collaborate with representatives from the outsourced billing vendor, Accountable Revenue Cycle Solutions, to address and resolve claim denials for missing prior authorizations Assisting with the education of patients and families in the various cardiac procedures Communicate with the designated hospital staff to schedule the ordered procedures Schedule the patient for the procedure and handle any scheduling issues Communicate with the designated facility and the patient once the procedure is finalized Observe patients, charts, and report changes in patients’ conditions, such as adverse reactions to medication or treatment, and take any necessary action Measure and record patients’ vital signs, such as height, weight, temperature, blood pressure, pulse, or respiration Report patient status to nurses, nurse practitioners, and/or physicians Update patient records and perform clerical work when necessary Respond to patient calls and will determine the appropriate way to assist them Collect samples when appropriate Set up equipment, prepare medical exam rooms, and escort patients when needed Other nursing, prior authorizations and medical office duties as assigned Qualifications Minimum of 2 years of experience as a Licensed Practical Nurse (LPN). Active licensed LPN in the State of Georgia. (Required) Experience in cardiology or device management a plus. Familiarity with electronic medical record system. Knowledge of infection control protocols and practices.

Cardiology experience:

Preferred Experience utilizing electronic medical record: Required – eClincialWorks (eCW) experience: Preferred Excellent communication and interpersonal skills: Required Able to work in a fast-paced medical practice while maintaining a high level of professionalism Ability to work well with physicians, employees, patients, and referral sources Detail oriented, thorough, and exact. Please note that this job description is not exhaustive and may be subject to change based on the needs of the healthcare facility.

Job Type:

Full-time Pay:

$24.00 – $28.00 per hour

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance

Medical Specialty:

Cardiology Supplemental Pay:

Overtime pay

Experience:

LPN:

2 years (Required)

License/Certification:

State of Georgia LPN license (Required) Ability to

Commute:

Ringgold, GA 30736 (Required) Ability to

Relocate:

Ringgold, GA 30736: Relocate before starting work (Required)

Work Location:

In person