LPN – Notice Of Action Letter Auditor
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Job Description
LPN auditing notice-of-action letters for CVS Health’s healthcare services operations. Applying clinical guidelines to ensure timely, accurate member and provider communications.
Responsibilities:
- Utilize clinical and critical thinking skills to complete notice of action (NOA) letters for members and providers for approved or denied services
- Write and audit notice of action letters
- Collect information to support appropriate, member-friendly notice of action letters
- Apply clinical experience, criteria/guidelines, policies, and procedures to ensure letters are timely and accurate
- Promote and support quality effectiveness of Healthcare Services and benefit utilization
- Work closely with the utilization management team
- No travel required
Requirements:
- LPN/LVN with current unrestricted licensure required
- 1 year of outpatient clinical experience required
- Licensed Practical/Vocational Nurse diploma or Associate Degree
- Sunday availability required
- Ability to work within Letter Team operating hours of 7am–7:30pm EST
- 2 years managed care experience preferred
- 2 years prior authorization experience preferred
- Prior experience using Quadient and/or MedCompass preferred
- Knowledge of Medicare/Medicaid preferred
- Exceptional attention to detail preferred
- Strong grammar, proofreading, and writing skills preferred
- Critical thinking and analytical abilities preferred
- Ability to interpret clinical documentation and guidelines preferred
- Strong judgment and decision-making skills preferred
- Auditing and quality review experience preferred
- Ability to prioritize and meet deadlines preferred
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility
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