[Hiring] Authorization Coordinator / Licensed Practical Nurse (LPN) @Sentara Health

Role Description

Sentara Health Plans is hiring an Authorization Coordinator / Licensed Practical Nurse (LPN) for LTSS/ Medicaid - Remote in Virginia!

• 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.

Qualifications

• HS - 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, such as experience in a physician office, acute care, managed care or clinic setting (REQUIRED)
• Authorizations or LTSS or Medicaid experience (highly 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
• 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.