LPN Authorization Coordinator

Glenwood Regional Medical Center • West Monroe, LA

51d

About The Position

The LPN Authorization Coordinator communicates with payors to obtain necessary authorizations for patients requiring post-acute placement. This role involves providing clinical information to payors under the direction of a Utilization Review (UR) nurse, documenting authorization numbers, concurrent denials, and attempts to overturn denials. The coordinator also facilitates the coordination of concurrent denial appeals between physicians and insurance providers, collaborates with Patient Access, Case Managers, UR nurses, and physicians to secure authorizations, and escalates potential disputes or denials to the Director of Case Management or UR nurse in a timely manner.

Requirements

• Louisiana licensed LPN required
• Experience with Microsoft Office, Word, Excel, and Outlook required
• Excellent communication skills, both written and oral required
• Demonstrates initiative and pro-active approach to problem resolution
• Demonstrates good organizational skills and attention to detail
• Ability to work independently with little supervision

Nice To Haves

• Experience with EMR strongly preferred
• 2 to 4 years' healthcare experience preferred

Responsibilities

• Validates daily that all Managed care/Commercial cases have an appropriate authorization and notify DCM or UR nurse of variances
• Document authorization and denial information in Care Management documentation system
• Submits initial clinical information within 24 hours of admission as directed by UR nurse
• Concurrently make sure all clinical needed by payors or updates provided by alerting UR nurse and/or DCM
• Coordinate Peer-to-Peer arrangements between physicians and insurance providers on denials when appropriate and document outcome
• Maintains confidentiality of patient/physician/personnel information/hospital proprietary information
• Performs other duties as assigned
• Maintains licensure/certification, BLS, etc. as required

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED