Licensed Practical Nurse (LPN)

Job Summary

A company is looking for a Payment Integrity - Clinical LPN.

Key Responsibilities

• Receive, review, and track Single Case Agreement (SCA) requests for completeness and accuracy
• Support Care Managers and Payment Integrity teams by gathering clinical documentation for out-of-network services
• Serve as a liaison between providers and internal teams regarding SCA documentation requirements

Required Qualifications

• Active, unrestricted Licensed Practical Nurse (LPN) license in the applicable state(s)
• 2+ years of clinical or healthcare administrative experience
• Working knowledge of healthcare benefits, out-of-network services, and medical terminology
• Strong organizational skills with the ability to manage multiple cases simultaneously