preauth nurse

Specialties Case Management

Published

I just recently interviewed for Prior Auth Nurse and I am excited about the position. I currently work for insurance company that does Short Term Disability claims. They are outsourcing nurses to other countries, therefore I am looking for something else. I have about 18 years of acute care experience. I have asked for 65,000 -70,000 , and they said it is possible. What is your opinion about this offer?

Thanks.

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.

Too many variables to say.

State, city? Big company, little?

Current demand for experienced nurses in your area?

Specializes in critical care, ER,ICU, CVSURG, CCU.

Roster'so questions, exactly

TheCommuter, BSN, RN

102 Articles; 27,612 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Pay is dependent upon variables such as experiential level and geographical location. Hence, no one would know if $65,000 to $70,000 is a competitive salary range without knowing where you are located.

I'm a case management RN for a major insurance company and our pre-authorization RNs earn more than $70,000 annually.

KariZayBSN

29 Posts

Specializes in Tele, Med/Surg, Geri, Case Manager.

Be prepared to work for every bit of your money. I don't think that's a good deal IMHO. I know you are excited but I want to provide a little insight if I may :D

Prior Auth is a LOT of headaches so be prepared. I would NOTdo it for that amount..but then again I would not do Prior Auth. If you still want to try it out here is a few pointers:

-You should be a quick learner as training can be overwhelming at times.

-Brush up on your ICD 10 code knowledge

-Be prepared to have to explain adverse determination to MD offices and patients/members (who sometimes are prepared to curse you out)

- Look forward to enjoying multiple phone calls from providers to check if you completed a review of clinical

-Enjoy being on a phone queue while you are trying to complete reviews, call out to providers, and discuss cases with your medical director

-Look forward to being production based and having to work long hours with occasional weekend and holiday (oh yes) coverage to meet "business needs"

For Utilization review that salary would be okay. Less stress and headache. No crazy demands to work overtime. And best of all very few calls to facilities. Try asking for a solid $70k min.

God bless you in your endeavors.

Kari,

Thank you for your input. I work with The ICD10 codes, however I do have a program that will show me the code if I put the diagnosis in. Are you saying I will have to know all the codes memorized?

I also work in the queue and have to be quick with diagnosing a patient and approving a claim. Do you believe this will be more brutal?

I am leaving Hartford because they are outscoring nurses to Philippines to approve the claims. This is a start for me. The company I am starting with is called Centene. Probably not the richest company in the U.S., but I have to start somewhere. What computer programs do I need expect to use frequently- PowerPoint, Excel..?

Orlando, Florida

TheCommuter, BSN, RN

102 Articles; 27,612 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Orlando, Florida
Thanks for providing your location. Unfortunately, the salaries in Florida tend to be 15 to 20 percent lower than the national average because you all are 'paid in sunshine.'

well, they gave us 6 days of training and that includes InterQual. Is that a standard process? I feel a little weird..

How is your experience going with Centene? I applied for a position with them as an RN Care Manager II.

Dyessrn

6 Posts

Thanks for that response KariZayBSN! Very informative. What do you do currently with the insurance companies? I have been thinking about case management and utilization review with insurance companies and would like as much information on the two positions as possible. Again your response was very helpful.

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