LPN Medical Reviewer I (Remote)

What we offer: Remote work opportunity (after a week of onsite training). Supportive team environment. Opportunity to make a difference in member health.

Job Title: LPN Medical Reviewer I Location: Columbia, SC, 29229 (1 to 2 week onsite training then remote) Duration: 3 months assignment with possible conversion Shift: M - F, 8:30 am - 5 pm Pay Rate: $23/hr In this role, you'll review medical records, ensure accurate coverage decisions based on medical necessity, and sometimes interact with providers and members.

Analyze medical records using established guidelines. Determine coverage and precertification for medical services. Collaborate with healthcare professionals to obtain additional information (if needed). Educate members and providers on coverage determinations.