LPN Utilization Management Coordinator
A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization. Key Responsibilities Monitor resource utilization, risk management, and quality of care for patients Obtain and maintain documentation for services in line with reimbursement agency guidelines Input collected data into systems for insurance communication and ensure medical necessity during patient hospitalization Required Qualifications Seven years of relevant experience with a minimum of one year in healthcare or clinical settings Currently holds an unencumbered Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) certification Experience in healthcare reimbursement, insurance industry, and/or authorization preferred Possesses relevant coding certifications such as CCS, CCS-P, CPC, CPC-H, COC, or CAC Appropriate education level as required by licensure
A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization.
Key Responsibilities
Monitor resource utilization, risk management, and quality of care for patients
Obtain and maintain documentation for services in line with reimbursement agency guidelines
Input collected data into systems for insurance communication and ensure medical necessity during patient hospitalization
Required Qualifications
Seven years of relevant experience with a minimum of one year in healthcare or clinical settings
Currently holds an unencumbered Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) certification
Experience in healthcare reimbursement, insurance industry, and/or authorization preferred
Possesses relevant coding certifications such as CCS, CCS-P, CPC, CPC-H, COC, or CAC
Appropriate education level as required by licensure
