LPN openings with a major healthcare / managed care company in the Cleveland, OH area! Hiring ASAP!! Apply now for consideration with Silvana Manzella at A-Line Staffing!

**Remote needs to live in the Southwest, Southeast, or Northeast OH areas of the following counties for some field visits

Pay: $28-$35 per hour dependent on experience

Schedule: Monday – Friday 8am-5pm

• 100% Remote for now but there could be Member facing visits as needed

Job Responsibilities:

• Initiate authorization requests for output or input services in keeping with the prior authorization list
• Maintain integrity of PHI and working relationships with other departments
• Research claims inquiry specific to the department and responsibility
• Attend ongoing training and inservices as directed, and perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results
• Assess and monitor inpatient census and screen for eligibility and benefits
• Identify members without a PCP and refer to Member Services and answers phone queues and faxes within established standards
• Coordinates services with community based organizations, and attend marketing and outreach meetings as directed to represent the plan
• Produces and mails routine CM letters and program educational materials, and assist develop marketing and outreach meetings as directed to represent the health plan
• Train new Program Coordinators on system and usage and guide staff regarding benefits, authorization requirements and policy and procedures
• Data enter assessments and authorizations into the system and maintain database as directed

Requirements:

• LPN License
• 3-5 years managed care or physician’s office experience.
• Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer.
• Knowledge of medical terminology.
• Associate’s or Bachelor’s Degree

Preferred Skills/Experience:

• Electronic Health Record knowledge
• Interdisciplinary communication experience
• Comfortable with behavioral health diagnosis

Apply for consideration with Silvana Manzella at A-Line!

Requirements:

• LPN License
• 3-5 years managed care or physician’s office experience.
• Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer.
• Knowledge of medical terminology.
• Associate’s or Bachelor’s Degree