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

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Accountable for reviewing clinical information received from Physicians and other clinical providers to ensure that the clinical data is adequate for authorizing services.

• Evaluates clinical information to confirm that the requested services are authorized in accordance with clinical protocols.

• Responsible for verifying member benefits for the services being requested.

• Confirms the precision of insurance enrollment information in the system before authorizing services.

• Requires an understanding of managed care contracting, clinical protocols, and clinical review standards.

• Requires familiarity with regulatory and compliance requirements applicable to government payers, self-funded, and commercial payers.

• Ensures that accurate and appropriate information is inputted into the claims system for payment processing.

⛳️ Requirements

• A minimum of 3 years of relevant clinical experience as an LPN, including experience in a physician office, acute care, managed care, or clinic environment is REQUIRED.

• Experience with authorizations, LTSS, or Medicaid is highly preferred.

• Must possess a Licensed Practical Nurse (LPN) nursing license - Compact/Multi-State License is REQUIRED.

• High School Graduate or equivalent is REQUIRED.

🏝️ Benefits

• Medical, Dental, and Vision plans.

• Adoption, Fertility, and Surrogacy Reimbursement up to $10,000.

• Paid Time Off and Sick Leave.

• Paid Parental and 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 the established system and employee eligibility criteria are met.