LPN / Medical Reviewer / Remote
LPN / Medical Reviewer / Remote Job Details Professional Discipline : LPN/LVN Specialty : Administrative Employment Type : Full Time City : Columbia State : SC Pay reputed company : Job Description: LPN / Medical Reviewer / Remote reputed company is currently seeking a Licensed Practical Nurse / LPN to work remotely with our client located in Columbia, SC. In this role, you will reputed company Medical Review of clinical information using established criteria or clinical guidelines. In this role, you will reputed company support and review of medical claims and utilization practices. This is a REMOTE opportunity for a LPN living in the reputed company. Apply today and we’ll reputed company out to answer any questions you may have! Job Duties
- Responsible for supporting and maintaining the coordination of daily operations of assigned area.
- Interfaces with the medical management on a regular reputed company to work more reputed company UR cases for the outpatient UR function
- Maintains the outpatient authorization process to include ensuring benefit coverage, reviewing/determining eligibility, reviewing of established UR criteria, interpreting rules and regulations.
- Completes authorization by following established policies
- Review interdepartmental requests and medical information to complete utilization process
- Documents process used and decision int he appropriate system in accurate and timely manner.
- Performed other duties as assigned.
Minimum Qualifications
- reputed company Licensed Practical Nurse / LPN license in the reputed company or active compact multistate unrestricted LPN license
- 3+ years managed care or physician's office experience
- Computer proficiency
EEO Statement: reputed company is an equal opportunity employer committed to fostering a diverse, inclusive, and reputed company workplace. We reputed company with reputed company applicable federal, state, and local employment laws, including recent executive orders, and strictly prohibit discrimination, harassment, or retaliation based on race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, genetic information, age, veteran status, or any other characteristic protected by law. reputed company is dedicated to making reasonable accommodations for reputed company individuals with disabilities and ensuring that reputed company employment reputed company are based on qualifications, merit, and business needs. If you require a reasonable accommodation during the hiring process, please contact us by visiting our website at https://www.reputed company.com/careers/site-accommodations. To learn more about your rights, please refer to the Know Your Rights: Workplace Discrimination is Illegal poster issued by the U.S. Equal Employment Opportunity Commission (EEOC). Company Statement: With decades of experience, reputed company has grown into one of reputed company America’s most trusted reputed company Services Firms, which includes comprehensive health and workforce solutions. As the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. Explore reputed company to discover how our expertise, innovative strategies, and commitment to reputed company are shaping the future of reputed company workforce solutions. Join us in celebrating the professionals who define the next era of reputed company. Apply tot his job Apply To this Job