Related skills
authorization lvn medicare medicaid utilization management📋 Description
- Review and audit authorization requests to ensure services meet medical guidelines.
- Chart audits of consults, imaging, and procedures to determine follow-up.
- Oversee departmental inboxes and queues to ensure proper handling of documents and requests.
- Identify and correct inconsistencies in participants' charts with authorizations in UM system.
- Review prior authorization requests for medical necessity and care plan alignment.
🎯 Requirements
- Minimum of one year chart auditing or UM review experience.
- Knowledgeable in Medicare and Medicaid UM regulations.
- Unencumbered LVN licensure.
🎁 Benefits
- Medical insurance coverage (Medical, Dental, Vision)
- PTO: 17 days, 12 holidays, and sick time
- 401K savings + match
- Advancement opportunities - track record of promoting from within
- And additional benefits
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