Remote LPN Authorization Coordinator Health Plan

Sentara Health; Richmond (VA); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reim

Paid Time Off & Sick Leave

Parental & Family Caregiver Leave

Life Insurance

401k/403B with Employer Match

Tuition Assistance – $5,250/year

Job summary

Sentara Health Plans in Virginia is hiring an Authorization Coordinator /Licensed Practical Nurse (LPN) for Imaging/Commercial roles in a remote Virginia-based position. You will review clinical information from physicians to determine authorization and verify benefits, ensuring compliance with NCQA, MCG, and InterQual standards.

The role requires an LPN license and 3 years of related clinical experience in managed care or physician office settings.

Qualifications

• HS or equivalent required.
• LPN licensure required; compact/multi-state license preferred.
• 3 years of related clinical experience as an LPN in physician offices, acute care, managed care, or clinic setting.

Responsibilities

• Review clinical information from physicians to determine authorization.
• Analyze information to ensure services are authorized per clinical protocols.
• Validate member benefits prior to authorization.
• Enter accurate information into the claims system for processing.

Skills

LPN License

Prior authorizations

Clinical review

Managed care knowledge

Education

HS - High School Grad or Equivalent

LPN Diploma or Associate level degree

Job description

Sentara Health Plans in Virginia is hiring an Authorization Coordinator /Licensed Practical Nurse (LPN) for Imaging/Commercial roles in a remote Virginia-based position. You will review clinical information from physicians to determine authorization and verify benefits, ensuring compliance with NCQA, MCG, and InterQual standards.

The role requires an LPN license and 3 years of related clinical experience in managed care or physician office settings.