Authorization Coordinator, Licensed Practical Nurse (LPN) – LTSS, Medicaid

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⚔️ Virginia – Remote

⚔️ Virginia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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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

• 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.

🎯 Requirements

• 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 • Licensed Practical Nurse (LPN) - Nursing License - Compact/Multi-State License REQUIRED • HS - High School Grad or Equivalent REQUIRED

🏖️ 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 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.