Job Title: Licensed Practical Nurse (LPN) - Remote | Work From Home
Job Overview
We are seeking a dedicated and detail-oriented Licensed Practical Nurse (LPN) specializing in Prior Authorization to join our esteemed team in a fully remote capacity. This non-patient-facing role is designed for skilled professionals who thrive in communication, organizational tasks, and case management while collaborating effectively with fellow healthcare experts.
Key Responsibilities
- Process and communicate specialty medication prior authorization (PA) requests evaluated by the Prior Authorization department.
- Collaborate with physician office personnel, customer service representatives, and pharmacy operations to relay PA status information.
- Manage fax processing and provide telephone support to prescriber offices, pharmacies, and members.
- Address inbound phone inquiries, process electronic authorization cases, and conduct follow-up calls with professionalism and courtesy.
- Maintain precise documentation, including system data entry and reporting.
- Review and process criteria-based prior authorizations in accordance with established policies and procedures.
- Offer on-call after-hours nurse support for urgent PA requests.
- Assist the PA team and member services department by providing internal nurse support.
- Refer complex cases to Pharmacists and Medical Directors when necessary.
- Adapt to shifting priorities with a strong sense of urgency in all tasks.
- Train and mentor team members to enhance performance and accuracy.
- Ensure compliance with HIPAA guidelines and uphold a confidential, distraction-free work environment.
Required Skills
- Active and unrestricted LPN license.
- 1-3 years of relevant experience, ideally in prior authorization, case management, or a similar healthcare function.
- Strong customer service aptitude, demonstrating a friendly and confident demeanor.
- Proficient in computer skills, with experience in Microsoft Office (Excel, Word, Access) and web-based applications.
- Capability to navigate eligibility systems and accurately handle prior authorization requests and appeals.
- Exceptional organizational abilities, attention to detail, and effective multitasking skills.
- Strong verbal and written communication capabilities.
- Ability to function independently while being an integral part of a team.
- Experience with report creation and maintenance is advantageous.
- Must possess a private, high-speed internet connection (minimum 25 Mbps download / 3 Mbps upload) and a dedicated workspace to ensure HIPAA compliance.
- Compliance with COVID-19 vaccination requirements (subject to approved medical or religious exemptions).
Career Growth Opportunities
This position provides opportunities for professional development and the enhancement of clinical knowledge in the prior authorization field, along with chances to mentor and train fellow team members.
Company Culture And Values
We pride ourselves on fostering a collaborative and supportive team environment where team members are encouraged to expand their clinical capabilities and work within a flexible setting.
Compensation And Benefits
- 100% remote work opportunity with a flexible schedule.
- Competitive salary and comprehensive benefits package.
If you are a compassionate and detail-oriented LPN seeking a rewarding remote opportunity in the healthcare sector, we invite you to apply today!
Employment Type: Full-Time
