Job Summary
The Administrative Nurse is responsible for facilitating clinical reviews and managing utilization processes by handling authorization requests and overseeing medical documentation. This role includes verifying benefits and collaborating with business partners to address issues related to authorizations or providers.
Responsibilities
- Process authorization requests for clinical reviews.
- Manage medical documentation related to reviews.
- Perform benefit verification for services.
- Coordinate with business partners to resolve issues concerning authorizations or providers.
Qualifications
- A minimum of 3 years’ experience in clinical, managed care, or utilization management environments.
- A valid Florida LPN license is required.
- A high school diploma or GED is mandatory.
- Proficiency in Microsoft Office applications.
- Strong communication skills are essential for this role.
