Question on prior auth RN

[Butterfly80RN]

Hi,

I'm looking for more insight as a work at home pre auth nurse. It would be review of cases for medical necessity. It is for a smaller company and I cannot find much info on it.

A friend of mind works for a large insurance company doing the same thing. She has a laptop and has no problem completing her cases. She is also rarely on the phone (which I really like!). Anyways, they're not ever hiring! She has showed me what she does. She pulls from a bank of cases for pre auth, opens the members benefits coverage, compares it to what the member is needing and submits an approval or denial.

I'm full time and need part time.

i currently work as a Care Manager for a large insurance company and I can't stand it! I'm on the phone all the time attempting to talk to people who have no interest in speaking with me. The focus on numbers, percentages, talk times, call audits is overkill to me. Absolutely no autonomy. I rarely feel useful as a nurse and more like a telemarketer.

I have aver read mixed things on pre authorization. I'm looking for others experiences.

Thanks!

[Been there,done that, ASN, RN]

I am a utilization management nurse, duties sound identical to your friend's.

I however have call center responsibilities. I do use my nursing judgement and clinical skills.

You have the appropriate background for this position as a case manager. Are your familiar with the InterQual and Milliman screening tools?

Do job research for all of your local health insurers, as well as United Health Group, BCBS, etc.

You got this, just focus on your plan.

[Riawahine, BSN, MSN]

Hi,

I'm looking for more insight as a work at home pre auth nurse. It would be review of cases for medical necessity. It is for a smaller company and I cannot find much info on it.

A friend of mind works for a large insurance company doing the same thing. She has a laptop and has no problem completing her cases. She is also rarely on the phone (which I really like!). Anyways, they're not ever hiring! She has showed me what she does. She pulls from a bank of cases for pre auth, opens the members benefits coverage, compares it to what the member is needing and submits an approval or denial.

I'm full time and need part time.

i currently work as a Care Manager for a large insurance company and I can't stand it! I'm on the phone all the time attempting to talk to people who have no interest in speaking with me. The focus on numbers, percentages, talk times, call audits is overkill to me. Absolutely no autonomy. I rarely feel useful as a nurse and more like a telemarketer.

I have aver read mixed things on pre authorization. I'm looking for others experiences.

Thanks!

Wondering if you ever got that position for WAH prior Auth ??