Utilization Review Specialist LPN

Job Description

Job Description

Job Title: Utilization Review Specialist LPN
Job Location: Baton Rouge, LA
Company: Seaside Health System

Seaside Health System is seeking a dedicated and compassionate Utilization Review-LPN to join our team in our Baton Rouge Inpatient Hospital. As a Utilization Review Specialist LPN, you will play a vital role in ensuring the highest level of clinical excellence and excellent patient care. If you value integrity, dignity, and respect, and are passionate about treating patients and colleagues with compassion, we invite you to apply for this full-time opportunity.

About the Role:

As a Utilization Review Specialist LPN, you will be responsible for reviewing patient information upon admission and submitting clinicals to external insurance companies to obtain precertification in a timely manner. You will also monitor information copied and sent to insurance companies, ensuring that only the required information is disseminated. Additionally, you will be available for on-call as needed, fax or call-in all discharge clinicals, and assist patients with Medicaid applications.

Responsibilities:

• Reviews patient information upon admission and submits clinicals to external insurance companies to obtain precertification in a timely manner.
• Monitors information copied and sent per request to insurance companies for inpatient and assures only the required information is disseminated.
• Available for on-call as needed.
• Fax or call-in all discharge clinicals to insurance companies in a timely manner.
• Assists patients with Medicaid Applications.
• Updates UR Logs daily.
• Contacts Physicians, nurses, social services, and other appropriate staff regarding potential problems or questions related to documentation of patient care issues.
• Other duties as assigned/required.

We Offer:

• BC/BS LA Health Insurance available
• Competitive Salaries based on experience
• Collaborative family environment with supportive colleagues
• Mentoring by senior nursing staff who are committed to your success and professional development
• Established clinical protocols, policies, and procedures based on outcomes and evidence-based practice
• Medical, Dental, Life, AD&D insurance and generous Paid Time Off (PTO) program

Equal Employment Opportunity:

Seaside Health System is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or disability in accordance with local, state, and federal laws.

Americans with Disabilities Act:

Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

If you are a motivated and compassionate LPN with a passion for delivering high-quality patient care, we encourage you to apply for this exciting opportunity.