LPN Case Manager - Steadfast Employment

Local third party instance office looking to hire LPN case manager in the Houma area! Hours are Monday through Friday 8am to 5pm. 

Responsibilities

· Review chart documentation to ensure patient meets medical policy guidelines

· Prioritize incoming authorization requests according to urgency

· Obtain authorization and follow up regularly on pending cases

· Review up to date requirements needed to successfully obtain authorizations

· Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order

· Review appeals for denied authorization

· Meet weekly with the Third Party Administrator to review authorizations

· Notify TPA of critical cases for referral to case management

· Maintain client’s records by reviewing case notes: logging events and progress

· Advocate for needed services for the patient; obtain additional resources

· Follow-up with patient by providing personal support

· Correspond with medical providers regarding plan of care

Knowledge, Skills and Abilities

· Knowledge of the authorization procedure and its direct impact on the client’s expenses

· Proficient use of CPT and ICD-10 codes

· Excellent computer skills including Excel, Word, and Internet use

· Detail oriented

· Plans and prioritizes to meet deadlines

· Excellent customer service skills; communicates clearly and effectively

· Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Education/Experience Required

· Licensed Practical Nursing license

· Prior medical authorization/case management experience preferred

Knowledge, Skills and Abilities

· Knowledge of the authorization procedure and its direct impact on the client’s expenses

· Proficient use of CPT and ICD-10 codes

· Excellent computer skills including Excel, Word, and Internet use

· Detail oriented

· Plans and prioritizes to meet deadlines

· Excellent customer service skills; communicates clearly and effectively

· Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Education/Experience Required

· Licensed Practical Nursing license

· Prior medical authorization/case management experience preferred