LanceSoft, Inc. – Prior Authorization LPN/LVN
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- Posted 2 weeks ago
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Job Detail
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Job ID 2956
Job Description
Job Description:
Job Title: Licensed Vocational Nurse/Licensed Pratitional Nurse
Location: Fully remote (never coming onsite)
Duration: 6+ Months
Description:
** This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area away from distractions and must have their own secure private internet services of at least 25mbps download/3mbps upload in order to ensure sufficient speed to adequately perform work duties. Must provide a screenshot of internet speeds with resume and provide license number.
Duties:
- Responsibilities include answering inbound phone calls, processing cases and electronic authorizations, loading authorizations, and making follow-up phone calls utilizing appropriate courteous and professional behavior based upon established standards.
- Maintaining complete and accurate, documentation of all necessary information is necessary and will involve computer system data entry, data management, and reporting.
- Review criteria-based prior authorizations following policy and procedure.
- Provide on-call after hours nurse availability for urgent PA requests.
- Provide internal nurse support to the PA team and member services department .
- Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).
- Shift priorities while exhibiting a high level of urgency with all calls and assignments.
- Excellent verbal and written skills.
- You will work with pharmacists, other clinical colleagues, healthcare professionals and members.
- Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
- Train and mentor representatives on the PA team.
- Complete other PA assignments as delegated by the PA leadership team.
Experience:
- Minimum of one-year related work experience to include working with an electronic medical record in a high call volume environment.
Education:
The Licensed Practical Nurse is a graduate of a school of Practical or Vocational Nursing, approved by the State Agency and/or accredited by the National League for Nursing (Accrediting Commission (NLNAC)) at the time the program was completed by the applicant. The LPN/LVN must have a full, active and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory or Commonwealth of the United States or District of Columbia.
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