Staff Nurse - RN, Sr. - Medical Management leads the coordination between care providers and plan members with the goal of maximizing member benefits while managing costs. Oversees the assessment of medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and ensures compliance with established guidelines. Being a Staff Nurse - RN, Sr. - Medical Management assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources. Additionally, Staff Nurse - RN, Sr. - Medical Management applies the medical and reimbursement policies within the claim adjudication process. Typically requires a bachelor's degree in Nursing. Typically reports to a manager. Requires RN license. To be a Staff Nurse - RN, Sr. - Medical Management typically requires more than 5 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
We have a GREAT opportunity for a reliable, team player to become part of our team to assist patients in our primary care clinic. You will be rooming patients, obtaining vitals, and assisting the provider(s) with minor procedures. Additionally, you will be helping providers to order labs/x-rays, assist in management of prescription refill requests and prior authorizations, schedule and track patients, make referrals, triage patient phone calls and help with any various tasks needed for patient care. Hours will generally be 8 am-4:30 pm Monday-Friday.
Desired skills:
Positive Team Player
Computer Savvy- EMR experience, spreadsheets, etc.
Working Knowledge of Medical Terminology
Appointment Scheduling
Understanding of Medical Insurance (Incorporated in scheduling and to prepare billing for visits)
Maintain Accurate and Organized Records (Patient consent forms, billing, and daily logs)
Confident in Communication Skills
Highly Motivated
Three or more years of experience in a healthcare facility or private physician office is a plus (but not required)
Dependable attendance
Positive and professional attitude
Excellent patient care skills and ability to multitask.
Job Type: Full-time
Pay: $12.00 - $14.00 per hour
Benefits:
Medical specialties:
Schedule:
Work setting:
Work Location: In person
Clear All
0 Staff Nurse - RN, Sr. - Medical Management jobs found in Knoxville, TN area