LPN Medical Review Coordinator
Job Summary
Working remotely in a full-time capacity, the LPN Medical Review Coordinator will review medical data, determine certification decisions for precertification cases, and collaborate with medical review specialists to ensure compliance with MedWatch and URAC standards.
Key responsibilities
- Review and enter medical data into clinical records for utilization review
- Determine certification decisions for precertification cases and document findings according to MedWatch policy
- Collaborate with supervisors and specialists on cases lacking clinical information and manage follow-ups as needed
Required qualifications
- Associate's degree or equivalent education and experience
- Current unrestricted Licensed Practical Nurse (LPN) license in the state of practice
- Minimum of 3 years clinical nursing experience
- Proficiency in MS Office Suite products (Word, Excel, PowerPoint)
- Familiarity with utilization review processes and medical data analysis
Complete Job Description
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