Precertification LPN: Prior Auth & Medical Necessity

Ochsner Health; New Orleans (LA); On-site; USD 48,000 - 64,000; Full time

Job summary

Ochsner Health in Louisiana is seeking an experienced LPN to perform pre-service medical necessity reviews and obtain prior authorizations for inpatient and outpatient services. You will coordinate with physicians and staff to determine level of care and ensure documentation supports medical necessity, working with Revenue Cycle and Case Management as needed.

The role requires an LPN diploma, 3 years hospital-based patient care, and an active LPN license.

Qualifications

• Licensed Practical Nurse (LPN) diploma required.
• 3 years of hospital-based patient care experience required.
• Current LPN license in state of practice required.

Responsibilities

• Secure clinical documentation and perform pre-service medical necessity reviews to obtain prior authorizations.
• Maintain professional knowledge and relevant certifications.
• Ensure all regulatory requirements within department are met.
• Assist in day-to-day department operations.
• Support company goals and core values.

Skills

Healthcare software

Communication skills

Customer service

Medical terminology

Education

LPN diploma

Tools

EHR systems

Job description

Ochsner Health in Louisiana is seeking an experienced LPN to perform pre-service medical necessity reviews and obtain prior authorizations for inpatient and outpatient services. You will coordinate with physicians and staff to determine level of care and ensure documentation supports medical necessity, working with Revenue Cycle and Case Management as needed.

The role requires an LPN diploma, 3 years hospital-based patient care, and an active LPN license.