Job Description
Our Client, a Retail Pharmacy company, is looking for a Licensed Vocational Nurse-LPN for their Remote location. Responsibilities:
+ Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations
+ Review and process complex prior authorization requests using clinical criteria and supporting documentation
+ Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy
+ Review chart notes, claims history, and prior authorization history to make accurate determinations
+ Submit complete and accurate documentation to support determinations and avoid unnecessary delays
+ Identify cases requiring escalation and refer appropriately
+ Demonstrate critical thinking and problem-solving when information is unclear or incomplete
+ Apply internal workflows, job aids, and policies correctly and consistently
+ Adapt quickly ...
+ Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations
+ Review and process complex prior authorization requests using clinical criteria and supporting documentation
+ Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy
+ Review chart notes, claims history, and prior authorization history to make accurate determinations
+ Submit complete and accurate documentation to support determinations and avoid unnecessary delays
+ Identify cases requiring escalation and refer appropriately
+ Demonstrate critical thinking and problem-solving when information is unclear or incomplete
+ Apply internal workflows, job aids, and policies correctly and consistently
+ Adapt quickly ...