Prior Authorization Specialist - Inpatient Rehab - Kessler Institute for Rehabilitation - West (West Orange)

Kessler Institute for Rehabilitation

West Orange, NJ

Prior Authorization Specialist/Payor Relations Specialist ( RN , LPN )

This is an onsite position only.

This position works Monday through Friday, 9am - 5pm; NO weekends or holidays!

Advocate for patients to receive insurance coverage for the care and services they need, as a Prior Authorization Specialist.

As a Prior Authorization Specialist / Payor Relations Specialist (RN OR LPN) you will manage the pre-certification and prior authorization of referrals scheduled for admission to the acute inpatient rehabilitation hospital.

• Registered Nurse (RN) or Licensed Practical Nurse (LPN) required.
• Initiates, completed patient authorizations, including preadmission assessments to insurance companies.
• Exceptional customer service to increase, stabilize and grow conversions and referrals.
• Maintains documentation.
• Evaluates Non-Medicare benefits as verified by the Central Business Office or Rehab Admissions Coordinator. Reviews benefits with Admissions Coordinator for possible risk and applies/completes written guidelines as necessary to reduce or manage risk.
• Tracks approval and denials through TOC.

Minimum Qualifications

• Licensure as a Registered Nurse or LVN/LPN is required
• 2 years of direct experience in third party reimbursement required

Preferred Experience

• Previous Experience within a physical rehabilitation setting preferred
• Experience submitting prior authorizations and/or utilization review preferred.
• Experience working with Excel and databases

At our rehabilitation hospitals, our intense focus on high-quality results creates a challenging, fast-paced and extremely rewarding environment. We offer a comprehensive benefits package with a variety of options to meet your healthcare needs.

Other benefits of this position include: 

• Excellent Orientation Program
• Paid Time Off (PTO)
• Extended Illness Days (EID)
• Health, Dental, and Vision Insurance
• Prescription Coverage
• Life Insurance
• Short- and Long-Term Disability
• Continuing Education and Tuition Reimbursement
• 401(k) Retirement Plan
• Personal and Family Medical Leave
• A network of over 40,000 employees with huge growth and relocation opportunities

**Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.