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Precertification Nurse PRN
AdventHealth
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AdventHealth Greater Orlando Logo
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Details

Posted: 19-Jun-22

Location: Land O' Lakes, Florida

Salary: Open

Categories:

General Nursing

Internal Number: 22018298


Description

All the benefits and perks you need for you and your family:

  • Career Development
  • Whole Person Wellbeing Resources
  • Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: PRN- Per Diem

Shift: Day Shift

Location: 9441 Health Center Drive Land O' Lakes, Florida 34637

The community you’ll be caring for: AdventHealth Connerton

  • Specialty hospital for medically complex patients
  • Pulmonary and Vapotherm Center of Excellence
  • Staff consists of all Registered Respiratory Therapist, 65% BSN or above RN’s, Current staff certifications include CCRN, PCCN, CNML, WCNC, NEA-BC, and RN-BC
  • Onsite BSN completion program partnership with South University with staff discounted rate
  • Simulation Lab and Clinical Transition Pilot Program
  • Free prep courses for national certifications
  • Robust atmosphere for Clinicals - partnerships with multiple nursing, pharmacy, therapy and respiratory schools.
  • Preceptorship and residencies for Respiratory and Nursing
  • Opportunities to participate and lead in culturally diverse programs (Diversity, Equity & Inclusion, Employee Activity Committee, Spiritual Ambassadors)
  • Open-door campus culture promoting direct relationships with leadership and c-suite.
  • Full time chaplain on staff
  • Team Member rewards and recognition programs to include: Daisy (RN), Employee of the Quarter, Phil (Respiratory), Service Awards, TWCE as Nice

 

The role you’ll contribute:

Pre-Certification:  Manages the pre-certification and prior authorization of referrals scheduled for admission to Florida Hospital Connerton Long Term Acute Care.

Insurance Verification:  Responsible for the accurate and timely verification of patients’ insurance coverage for all admissions. Utilization Review: Assures medical necessity review criteria as mandated by the QIO is implemented for all admissions and continued stays.  Completes InterQual reviews for continued stay review and shares with the payer as per request.  Advises Case Manager and Director of Business Development of any patients no longer meeting criteria or denials of continued stay immediately.

 

The value you’ll bring to the team:

  • Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk.
  • Reviews Medicare benefits through Vision Share and Common Working File and accurately accounts for whether the patient has traditional Medicare or a Medicare Advantage plan.
  • Accesses Payor Information System to secure Billing and Reimbursement forms and Hospital Contracts to review accommodation codes.
Qualifications

The expertise and experiences you’ll need to succeed:

  • RN from diploma, Associate, or Bachelor’s degree
  • 1 Year Bedside RN in a complex patient care environment (ICU/PCU preferred)
  • 1 Year direct experience with third party reimbursement
  • 1 Year experience in case management in an acute care environment

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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About AdventHealth
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.
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