Precertification Nurse (LPN) - Revenue Cycle & Necessity

Ochsner Health; New Orleans (LA); On-site; USD 42,000 - 54,000; Full time

Job summary

Ochsner Health in Louisiana seeks an experienced LPN to support pre-service medical necessity reviews and prior authorizations for inpatient and outpatient services, ensuring payer requirements are met and documentation is complete.

You will collaborate with physicians and case management to determine the appropriate level of care, maintain regulatory compliance, and help the revenue cycle team deliver timely authorizations while upholding high standards of patient care.

Qualifications

• Proficiency in using hospital systems and standard software.
• Excellent verbal and written communication with diverse patients.
• Good customer service skills and ability to gather and disseminate information.

Responsibilities

• Secures clinical documentation and performs pre-service medical necessity reviews to obtain prior authorizations.
• Maintains professional knowledge and certifications.
• Ensures regulatory requirements are met within the department.
• Assists in day-to-day department operations.
• Supports revenue cycle goals and core values.

Skills

Clinical documentation

Verbal communication

Written communication

Customer service

Interpersonal skills

Time management

Critical thinking

Medical terminology

Education

LPN diploma

Job description

Ochsner Health in Louisiana seeks an experienced LPN to support pre-service medical necessity reviews and prior authorizations for inpatient and outpatient services, ensuring payer requirements are met and documentation is complete.

You will collaborate with physicians and case management to determine the appropriate level of care, maintain regulatory compliance, and help the revenue cycle team deliver timely authorizations while upholding high standards of patient care.