Remote LPN/LVN Prior Authorization Specialist

APIDEL LTD; United States; Remote; USD 60,000 - 86,000; Full time

Job summary

APIDEL LTD seeks an experienced Licensed Practical Nurse (LPN) to handle high-volume prior authorization in a fully remote setting. The role requires strong clinical judgment, accuracy, and independence to interpret clinical information across systems.

Ideal candidates have 2+ years of prior authorization experience in PBM, MDO, or clinical settings, and a current LPN license. Remote work demands accountability, focus, and seamless communication with teams and providers.

Qualifications

• Active, unrestricted LPN/LVN license.
• Minimum 2+ years of prior authorization experience in PBM/MDO/clinical setting.
• Experience applying clinical criteria using supporting documentation.
• Experience using CoverMyMeds or similar platforms.
• Licensed as an LPN in the state of residence.

Responsibilities

• Manage inbound and outbound calls while maintaining productivity and service levels.
• Review and process complex prior authorization requests using clinical criteria and documentation.
• Navigate multiple systems and platforms with speed and accuracy.
• Review chart notes, claims history, and prior authorization history to make determinations.

Skills

Prior Authorization

Clinical judgment

Attention to detail

Communication

Education

Practical Nursing Diploma (LPN)

Tools

CoverMyMeds

Job description

APIDEL LTD seeks an experienced Licensed Practical Nurse (LPN) to handle high-volume prior authorization in a fully remote setting. The role requires strong clinical judgment, accuracy, and independence to interpret clinical information across systems.

Ideal candidates have 2+ years of prior authorization experience in PBM, MDO, or clinical settings, and a current LPN license. Remote work demands accountability, focus, and seamless communication with teams and providers.