McFarland Clinic
Location
Ames, Iowa
Manage and prioritize prior authorization requests through various channels and monitor them until final determination. Coordinate with providers and insurance representatives to obtain clinical documentation and handle the appeals process for denials.
Must be a graduate of an accredited nursing school with a valid LPN or RN license and BLS certification. Preferred experience includes handling medication prior authorizations and appeals.
McFarland Clinic is currently accepting applications for Prior Authorization Specialist (LPN/RN) for its Ames office. Candidates should be service-oriented, a team player, and be able to provide extraordinary care, every day to our patients.
include: Complete and prioritize prior authorization requests received through the electronic health record, phone, fax, or payer websites, and monitor each request through final determination. Review requests for accuracy and completeness, obtain supporting clinical documentation, and submit medical records or referrals needed to expedite payer review. Communicate with providers, departments, nurse managers, and insurance representatives regarding medications, requirements, authorization status, and next steps. Review denials, identify appeal opportunities, obtain medically necessary information from providers, and submit appeals as appropriate.
Monday - Friday
Pre-employment drug screen and criminal history background checks are a condition of hire.
McFarland Clinic offers a comprehensive benefits package, including health and dental insurance, 401(k), and PTO. Click here [https://www.mcfarlandclinic.com/media/cms/BENEFIT_SUMMARY_2022Hourly_5698BB42CD3C6.pdf] for details.
McFarland Clinic is an Equal Opportunity Employer McFarland Clinic makes every effort to comply with all requirements of federal, state and local laws relating to Equal Employment Opportunity.
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