Clinic - Prior Authorization & Clinic Pain Contract Compliance Nurse

 Trego County Lemke Memorial Hospital's Clinic is looking for a full-time Prior Authorization & Clinic Pain Contract Compliance Nurse.

· Full-time position available

Position Overview

The Prior Authorization & Pain Contract Compliance position is a full-time role responsible for coordinating insurance prior authorizations and managing pain management services across the clinic. This role supports timely patient access to care, ensures compliance with payer requirements, and promotes efficient communication between providers, patients, and insurance carriers.

The position includes clinical review responsibilities related to pain management contract compliance. This role is essential in supporting patient care continuity and revenue cycle efficiency.

 

·         Obtain and process prior authorizations for imaging, injections, medications, and related services

·         Review provider orders and clinical documentation to ensure completeness and payer compliance

·         Communicate with insurance companies to verify coverage, benefits, and authorization requirements

·         Track authorization status, follow up on pending requests, and resolve denials or delays

·         Maintain accurate documentation within the electronic health record (EHR)

·         Collaborate with providers, nursing staff, and billing teams to ensure services are authorized prior to scheduling

·         Accepts other duties as assigned.

·      Coordinate and collaborate with providers and patients regarding pain contracts

·      Serve as the primary point of contact for pain management contracts

·         Communicate with providers regarding clinical concerns, urgency, or missing information

·         Provide patient education related to procedures, medications, and follow-up care

·         Maintain compliance with nursing standards, hospital policies, and regulatory requirements

·         Float Nurse as requested.

·         RN or LPN Current Kansas License

·         Current BLS Certification

·         Strong organizational skills with attention to details

·         Proficiency with electronic health records and basic computer applications

 

Our application must be completed to be considered for this position. Please send application, resume, education, licensure/certifications (if applicable)to Human Resources, 320 N 13th St., WaKeeney, KS 67672. They may also be dropped off at the hospital business office, emailed to hr@tclmh.org or faxed to (785) 743-6317. To request an application by mail or email, please email or call (785) 743-2182. Applications also available on our website: www.tclmh.org

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We are a progressive CAH hospital with in-patient, swing bed, out-patient, home health, assisted living, long-term care, and clinic services.

Candidates must be energetic, possess strong leadership skills, willing to work as a team, have a positive attitude, friendly and compassionate toward patients.

For hospital information: www.tclmh.org

For community information: www.tregocountyks.com

TCLMH is an Equal Opportunity Provider/Employer (EOE) and a tobacco free campus.