Authorization Coordinator – Licensed Practical Nurse, Imaging, Commercial

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🔥 0 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sentara Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1890

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Sentara Health is a leading healthcare system that operates over 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals. The company is dedicated to providing exceptional patient care, fostering professional development, and maintaining a diverse workforce. Sentara Health aims to improve health every day and has been recognized for its clinical and operational performance, being named one of the top 15 health systems by IBM Watson Health. The organization supports its employees in achieving their full potential and encourages growth and innovation in the healthcare sector.

📋 Description

• Review clinical information received from physicians and other clinical providers to ensure it is substantial enough to authorize services • Analyze clinical information to ensure requested services are authorized according to clinical protocols • Validate member benefits for requested services • Validate the accuracy of insurance enrollment information before authorizing services • Ensure appropriate and accurate information is entered into the claims system for payment processing

🎯 Requirements

• 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 REQUIRED • Experience may include a physician office, acute care, managed care, or clinic setting • Knowledge of managed care contracting, clinical protocols, and clinical review requirements • Knowledge of regulatory and compliance requirements for government payers, self-funded, and commercial payers • Familiarity with NCQA standards and turnaround times for prior authorizations • Familiarity with MCG and InterQual clinical decision support tools for prior authorizations and utilization review • LPN Diploma or Associate level degree preferred • Imaging and Health Plan experience preferred

🏖️ Benefits

• Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Pet Insurance • Legal Resources Plan • Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met • Family-friendly culture • Opportunities for development and growth • Tobacco-free environment