Medical Reviewer, LPN
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Job Description
Medical Reviewer LPN conducting pre-authorization reviews for HCSC. Focusing on utilization review and quality of care compliance.
Responsibilities:
- Responsible for pre-authorization reviews in accordance with medical contract and regulations
- Conduct utilization review and ensure quality of care
Requirements:
- LPN with valid, current, unrestricted clinical license in the state of operations
- 3 years of clinical experience in physician office, hospital, or surgical setting
- Customer service oriented to assist internal/external customers
- Verbal and written communication skills
- Interpersonal skills and ability to be a team player
- Willingness and ability to travel
- Familiar with PC or database systems
- Completion of additional applicable nursing licenses in other states if required by management
Benefits:
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Other incentives
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