Revenue Cycle Precertification Nurse- RN- Benson Tower- Remote

Revenue Cycle Precertification Nurse – RN – Benson Tower – Remote
, Ochsner Health

We are looking for a dedicated RN to secure prior authorizations for scheduled inpatient and outpatient services (excluding ED). The role supports the financial security of patient accounts by ensuring medical necessity documentation and collaborating with physicians, case managers, and the Revenue Cycle team.

• Coordinate with physicians and staff to obtain appropriate level of care and necessary clinical documentation.
• Perform pre-service medical necessity reviews to secure prior authorizations.
• Maintain regulatory and credentialing requirements; ensure compliance with medical and billing standards.
• Assist with day‑to‑day operations of the department.
• Support company and business service goals and core values.
• Perform related duties as required.

• Required:
  
  Graduate of an accredited school of nursing.
• Preferred:
  Bachelor’s degree in nursing.
• Required:
  
  1 year hospital‑based patient care experience.

• Required:
  
  Current RN license in the state of practice.

• Proficient with Windows applications and data entry.
• Strong written and verbal communication; ability to present information clearly.
• Good judgement, conflict resolution, and analytical skills.
• Excellent organizational and time‑management skills.
• Proficiency with medical‑necessity criteria, CPT, ICD‑10 coding, Medicare guideline, HMO and PPO contracts.
• Effective collaboration with other departments and functional areas.

Light physical work: occasionally lifting up to 20 pounds but primarily seated. No exposure to blood or hazardous materials. Requires adherence to safety and privacy regulations.

The employer is an Equal Opportunity Employer and provides accommodations for qualified individuals with disabilities.