Clinical Authorization Nurse at Gentiva in Mooresville, North Carolina

Job Description:

Our Company

Gentiva is an industry leader in hospice, palliative and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support to patients and their families so they may make the most of every moment. We believe that better care for caregivers and clinicians means better care for everyone, so we offer ongoing professional training, lower nurse-to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join gifted colleagues who make a lasting difference in people's lives every day.

Overview

We're looking for a Clinical Authorization Nurse to join our team.

You will report directly to the Billing Manager. You will be responsible for the oversight and operation of authorization/eligibility requirements and all processes as assigned.

• Review clinical information requirements from a variety of payer sources including Medicare, Medicaid, and commercial policies.
  
  


• Perform review of medical records and documentation with an emphasis on eligibility requirements
  
  


• Ability to sort and compile patient medical record information to be consistent with hospice eligibility requirements for Medicare, Medicaid, and various commercial policies


• Work with the field staff on obtaining all documentation necessary for clean claim billing

• RN license required, Bachelor's degree in Nursing preferred


• Three years of Home Care or Hospice experience


• Experience entering data into electronic systems

We Offer

• Comprehensive Benefits Package: Health Insurance, 401k Plan, Tuition Reimbursement, PTO


• Opportunity to Participate In a Fleet Program


• Competitive Salaries


• Mileage Reimbursement


• Professional Growth and Development Opportunities

• This is a safety-sensitive position


• Employee must meet minimum requirements to be eligible for benefits


• Where applicable, employee must meet state specific requirements


• We are proud to be an EEO employer


• We maintain a drug-free workplace

Gentiva