LPN / Medical Reviewer / Remote Job Details Professional Discipline : LPN/LVN Specialty : Administrative Employment Type : Full Time City : Columbia State : SC Pay Range : Job Description:LPN / Medical Reviewer / RemoteInGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our client located in Columbia, SC. In this role, you will perform Medical Review of clinical information using established criteria or clinical guidelines. In this role, you will provide support and review of medical claims and utilization practices.This is a REMOTE opportunity for a LPN living in the state of South Carolina. Apply today and we'll reach out to answer any questions you may have!Job DutiesResponsible for supporting and maintaining the coordination of daily operations of assigned area.Interfaces with the medical management on a regular basis to work more complex UR cases for the outpatient UR functionMaintains the outpatient authorization process to include ensuring benefit coverage, reviewing/determining eligibility, reviewing of established UR criteria, interpreting rules and regulations.Completes authorization by following established policiesReview interdepartmental requests and medical information to complete utilization processDocuments process used and decision int he appropriate system in accurate and timely manner.Performed other duties as assigned.Minimum QualificationsCurrent Licensed Practical Nurse / LPN license in the State of South Carolina or active compact multistate unrestricted LPN license3+ years managed care or physician's office experienceComputer proficiencyEEO Statement:InGenesis is an equal opportunity employer committed to fostering a diverse, inclusive, and equitable workplace. We comply with all applicable federal, state, and local employment laws, including recent executive orders, and strictly prohibit discrimination, harassment, or retaliation based on race, color, religion, sex, sexual orientation, gender identity, national origin, disability, genetic information, age, veteran status, or any other characteristic protected by law.InGenesis is dedicated to making reasonable accommodations for qualified individuals with disabilities and ensuring that all employment decisions are based on qualifications, merit, and business needs. If you require a reasonable accommodation during the hiring process, please contact us by visiting our website at learn more about your rights, please refer to the Know Your Rights: Workplace Discrimination is Illegal poster issued by the U.S. Equal Employment Opportunity Commission (EEOC).Company Statement:With decades of experience, InGenesis has grown into one of North America's most trusted Healthcare Services Firms, which includes comprehensive health and workforce solutions. As the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. Explore InGenesis to discover how our expertise, innovative strategies, and commitment to excellence are shaping the future of healthcare workforce solutions. Join us in celebrating the professionals who define the next era of healthcare.
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