Medical Nurse- Prior Approval Analyst

Company: Aerotek ( Learn More )

General Information
US-NC-Raleigh
N/A
Not Specified
Full-Time
Not Specified
Not Specified
False
False
Job Description

Job Description:

  • Analyzes prior approval requests for NC Medicaid to ensure compliance with clinical guidelines
  • Performs review of documentation submitted for prior approval requests for NC Medicaid patients
  • Specialized in medical, surgical, and out of state ambulance services to determine if the recipient is eligible for the services being requested
  • Use NC Tracks internal system to partner with North Carolina DHHS to get requests approved
  • Work Environment:

    Office/Clerical. Working on Prior-approval nurse team for Medicaid (MMIS) contract for the state of North Carolina Department of Health

    Qualifications:

  • 2+ years clinical nursing skills, claims review skills, communication skills, telephonic customer service skills and time management skills
  • 2 years nursing experience
  • Active NC license as RN (in good standing)
  • Must be comfortable with using a computer
  • Knowledge of Microsoft Office and Outlook
  • Hours:

    8am-5pm: Standard training hours

    Flexible hours possible once you've shown you can work independently




    About Aerotek:

    Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit aerotek.com.

    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email accommodation@aerotek .com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
    Job Requirements