Website FHN

Summary:  The Pre-certification Nurse provides pre-certification services for patients having procedures in the hospital and / or office settings based upon requirements set forth by the patient’s insurance plan.  The services provided insure FHN’s ability to bill accurate claims and receive timely reimbursement from the insurance companies. The Pre-certification Nurse utilizes a team approach and works in tandem with the Pre-Certification Customer Service Representative as well as with physicians, nurses, schedulers and registration staff in order to achieve optimal patient outcomes and proper reimbursement for FHN. Team members will coordinate discussions between insurance company physicians and FHN physicians when necessary and requested by the insurance company. The Precertification nurse will also accurately document the information obtained from the insurance companies in FHN’s Authorization and Referral Management module.

The Pre-Certification Nurse will adhere to departmental goals, objectives, standards of performance, as well as policies and procedures. They will ensure compliance with quality patient care as well as insurance and regulatory compliance. This position requires team members to possess strong communication, analytical and critical thinking skills.

Education/Experience:  Bachelor’s Degree in Nursing (RN) with 1-2 years experience with Coding, Case Management, and Insurance Theory, as well as 5-8 years of work related experience.

Chat with us now! Text “JOBS” to 815-600-7056.

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