Authorization Coordinator / Licensed Practical Nurse (LPN) for LTSS/ Medicaid - Remote in Virginia
Sentara Health
City/State
Norfolk, VA Work Shift
First (Days) Overview: Sentara Health Plans is hiring an Authorization Coordinator / Licensed Practical Nurse (LPN) for LTSS/ Medicaid - Remote in Virginia! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F. Location: This position is remote in Virginia. Job responsibilities:
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Norfolk, VA Work Shift
First (Days) Overview: Sentara Health Plans is hiring an Authorization Coordinator / Licensed Practical Nurse (LPN) for LTSS/ Medicaid - Remote in Virginia! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F. Location: This position is remote in Virginia. 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.
- Responsible for validation of member benefits for the services requested.
- 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.
- Ensures appropriate and accurate information is entered into claims system for processing of payment.
- HS - High School Grad or Equivalent REQUIRED
- Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License REQUIRED
- 3 years of related clinical experience as an LPN, such as experience in a physician office, acute care, managed care or clinic setting REQUIRED
- Authorizations or LTSS or Medicaid experience highly preferred
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Vacancy posted 1 hour ago
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