Clinical Authorization Specialist

Sentara Health; Norfolk (VA); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off and Sick Leave

401k/403B with Employer Match

Tuition Assistance – $5,250/year

Job summary

Sentara Health in Norfolk, VA is seeking an Authorization Coordinator to review clinical information from physicians and other providers, ensuring data supports service authorization according to clinical protocols.

The role requires a Licensed Practical Nurse (LPN), a High School diploma, at least 3 years of related experience, and familiarity with utilization management, regulatory requirements, and Milliman. Proficiency in Microsoft Word, Excel, and Outlook is preferred.

Qualifications

• 3 years of related experience (required)
• Utilization Management experience (preferred)
• Diagnostic Imaging experience (preferred)
• Microsoft Suite (Word, Excel, Outlook) preferred
• Milliman experience (preferred)

Responsibilities

• Review clinical information to authorize services according to clinical protocols.
• Validate member benefits and enrollment information prior to authorization.

Skills

Utilization Management

Clinical Review

Regulatory Compliance

Education

High School Diploma

Licensed Practical Nurse – LPN

Tools

Microsoft Word

Microsoft Excel

Outlook

Milliman

Job description

Sentara Health in Norfolk, VA is seeking an Authorization Coordinator to review clinical information from physicians and other providers, ensuring data supports service authorization according to clinical protocols.

The role requires a Licensed Practical Nurse (LPN), a High School diploma, at least 3 years of related experience, and familiarity with utilization management, regulatory requirements, and Milliman. Proficiency in Microsoft Word, Excel, and Outlook is preferred.