Pre-Authorization Coordinator - Registered Nurse - Acute Rehab

TriStar Health
A family of hospitals for your family. TriStar Health is the region's largest, most comprehensive healthcare provider with hospitals located in Tennessee, Georgia and Kentucky. The healthcare network of choice for thousands of people in the region, TriStar offers the convenience, comfort and individualized care you deserve from your healthcare provider.

At each of our locations, you can expect an outstanding selection of doctors, a dedicated team of healthcare professionals and advanced technologies used in everything from joint replacement surgery to cancer treatment.

Our Mission
"Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high-quality, cost-effective healthcare in the communities we serve."

TriStar Health is seeking a Pre-Authorization Coordinator - Registered Nurse (RN) - Acute Rehabilitation to work PRN/As Needed.

Position Summary

  • The Admission Coordinator assumes the responsibility for the coordination of an effective, efficient admission process for all patients by receiving referrals from the CRS, coordinating with the Clinical Rehab Specialist, gathering and verifying pertinent information, and completing necessary procedures to schedule and admit inpatients.
  • This position is a key pull-through for referrals and compiles and inputs statistical information into appropriate hospital systems.

Some of the Duties Include:
  1. Performs pre-certifications, insurance verifications and is responsible for the data integrity with regard to referral tracking
  2. Coordinates final admission approvals that come through communications with the Medical Director, Clinical Rehab Specialist and Program Director.
  3. Gathers and collects pertinent clinical information to aid in the insurance approval process.
  4. Accurately assesses patient condition, status, needs and medical record data for cost/benefit analysis and medical determination for program admissions.
  5. Accurately applies primary and secondary medical diagnostic information to support presentation of assessment/admission the insurance provider and all other necessary parties.
  6. Communicates effectively and timely with CRS, Program Director and/or Medical Director as needed, relaying non-Medicare insurance information, to allow for timely approval and admission.

  • Inpatient Acute Rehab and/or hospital admissions experience required; to include insurance pre-authorization and utilization review experience
    • Demonstrates working knowledge of acute rehab criteria, level of care requirements and medical necessity
    • Understands Medical terminology, regulations and parameters of third party reimbursements
  • Basic computer knowledge including Outlook, Excel, PowerPoint and Word required.
  • Licensed Clinician preferred (RN or LPN)

Apply Online Today to join this great TriStar Division Team!

Share this Job

Other Locations For This Job