Authorization Coordinator / Licensed Practical Nurse (LPN) for LTSS/ Medicaid - Remote in Virginia
Sentara Health · Virginia, United States · 2 days ago
HealthcareFull-time
Job Responsibilities
- Responsible for review of clinical information received from Physicians and other Clinical providers ensuring clinical data is substantial enough to authorize services.
- Analyzes clinical information to ensure the services requested are authorized according to clinical protocols.
- Validates accuracy of insurance enrollment information in the system prior to authorizing services.
- Requires knowledge of managed care contracting, clinical protocols and clinical review requirements.
- Requires knowledge of regulatory and compliance requirements for government payers, self funded and commercial payers.
- Safeguards appropriate and accurate information is entered into claims system for processing of payment.
Requirements
- High School Grad or Equivalent
- Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License
- 3 years of related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting
- Authorizations or LTSS or Medicaid experience highly preferred
Qualifications
- Education: HS - High School Grad or Equivalent REQUIRED
- Certification/Licensure: Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License REQUIRED
Skills
- Knowledge of managed care contracting
- Knowledge of clinical protocols
- Knowledge of regulatory and compliance requirements
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
Pay
- Commensurate with experience
Schedule
- First (Days)