Call Center LPN

Long Island Select Healthcare Inc.•Hauppauge, NY

36d

About The Position

To support patients and the clinical team by managing phone calls, medication refill requests and coordinating medication prior authorizations. This role serves as a clinical liaison between patients, pharmacies, providers, and insurance companies to ensure timely access to prescribed medications while maintaining compliance with regulatory and organizational standards. The Call Center LPN Representative provides clinical support by managing and coordinating incoming triage and nursing-specific calls. This role identifies patient concerns using established protocols , provides appropriate nursing guidance within scope of practice, and ensures timely escalation to providers or registered nurses as needed. The LPN serves as a key point of contact to promote patient safety, continuity of care, and positive patient experiences.

Requirements

Associate's degree (A. A.) or equivalent from two-year college or technical school and one to six months' related experience and/or training; or equivalent combination of education and experience.
New York State licensure as a Licensed Practical Nurse.
Certified in CPR.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers or employees of organization.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving several concrete variables in standardized situations.
To perform this job successfully, an individual should have basic to intermediate knowledge of Microsoft Office software (Outlook, Excel, Word), as well as Practice Management and Electronic Medical Record software.

Responsibilities

Receive incoming calls related to medication refill requests;
Review patient records to verify eligibility, dosage, and refill timing;
Process refill requests per provider protocols and clinical guidelines;
Communicate with pharmacies and providers to clarify or resolve refill issues;
Educate patients on refill processes, medication adherence, and timelines
Initiate, submit, and track medication prior authorizations with insurance payers;
Collect and document required clinical information to support authorization requests;
Communicate authorizations tatus to patients, providers, and pharmacies;
Follow up on pending or denied authorizations and escalate as appropriate;
Maintain accurate documentation in electronic health record (EHR)
Receive and assess incoming patient calls related to symptoms, clinical concerns, and care questions
Perform nursing triage using approved protocols, standing orders, and clinical guidelines;
Identify urgent or emergent conditions and escalate appropriately to RNs, providers, or emergency services;
Provide patient education and nursing guidance within LPN scope of practice;
Provide clear empathetic communication to patients via phone and electronic messaging;
Collaborate with physicians, nurses, medical assistants, and administrative staff;
Address patient concerns related to medication access and insurance requirements;
Ensure adherence to HIPAA, state nursing regulations, and organizational policies;
Accurately document all interactions, actions ,and outcomes in the EHR;
Meet productivity, quality, and customer service benchmarks;
Clinical judgment within scope of practice;
Patient safety and advocacy;
Time management and organization;
Maintain clear and honest documentation;
Collaborate and communicate effectively and efficiently on a team level;