LPN Claims Review (Non Clinical) Tempe, AZ

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POST DATE 8/31/2016
END DATE 10/18/2016

Ajilon Professional Staffing Mesa, AZ

Company
Ajilon Professional Staffing
Job Classification
Full Time
Company Ref #
23171995.16915798
AJE Ref #
576031650
Location
Mesa, AZ
Job Type
Regular
Required Licenses/Certifications
df-aj

JOB DESCRIPTION

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span LPN Claims Review (Non Clinical) Tempe, AZ br   br Location: Tempe, AZ br Position Summary: br   br Do you have your LPN certification but want to step away from patient care and work from home? This position has a work from home option after training is complete! Must have utilized your LPN certification at least 2-years to be considered. br • Applying clinical knowledge to make determinations for pre-authorizations of specific procedures and services to ensure adherence to contract benefits br • Conducts Medical / Surgical medical necessity reviews br • Compiles information needed to process prior authorization requests and documents in the medical management information system br • Prepares and presents more complex cases for Medical Director review br • Refer cases to Case Management and Disease Management as appropriate br • Advises non-clinical staff on clinical and coding questions br • Conducts pre-admission screening and assessments br   br Requirements:   br   br • Licensed Practical Nurse (L.P.N.) or Licensed Vocational Nurse, with current unrestricted license in ARIZONA br • Medical / Surgical experience br • Proficient working with on-line systems br • Must have at a minimum of  at least 2-years’ experience utilizing your LPN license br   br Compensation: $23-25 (DOE) br   br If you are qualified and interested, click on “APPLY NOW” to be considered for this position br   br /span