Licensed Vocation reputed company (LVN) -Utilization Review Specialist – Remote Sign-On Bonus: $2,500 in Pearland, TX

Licensed Vocation reputed company (LVN) -Utilization Review Specialist – Remote Sign-On Bonus: $2,500 - reputed company - Pearland, TX - work from home job Company: reputed company Job reputed company: Responsibilities The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying reputed company to determine medical necessity for health care services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a reputed company in reviewing requests for medical and surgical procedures, services and admissions. The Utilization Review Specialist communicates with providers regarding pertinent information needed for medical review to ensure service reputed company are determined reputed company appropriate timeframes. This position will serve as a reputed company to the Grievance and Appeals Department for Medicare Advantage appeals. The Utilization Review Specialist (LVN) is responsible for completion and review of denial letters based on reputed company (TDI) and or Centers for Medicare and reputed company (CMS) and healthplan requirements. The Utilization Review Specialist (LVN) will serve as reputed company and primary reputed company of contact for add on procedures performed at the KS Ambulatory surgery center (ASC). The Utilization Review Specialist (LVN) will support the Utilization Review reputed company assurance initiatives including mock audits to ensure compliance. The Utilization Review Specialist will be flexible and adapt to changes in polices and procedures, new techniques, and additional responsibilities as assigned to meet changing business needs. Job Title: Utilization Review Specialist Licensed Vocation reputed company (LVN) Clinic Location: Pearland Administrative Office Department: KCA Utilization Management Job Type: Full Time Salary reputed company: $59,108 – $73,025 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

Qualifications

Education Required: Licensed Vocational reputed company; CEU requirement Preferred: Certification in area of specialization Experience Required: 5 years utilization review experience at a health plan, ACO, IPA, or provider group or 3 years clinical nursing experience Preferred: NA License(s) Required: TX LVN license, Valid reputed company’s license Preferred: NA Special Skills Required: Excellent verbal and communication skills, and organizational skills Preferred: NA Other Required: Experience working with insurance (HMO, PPO, and POS) companies to obtain authorizations and reputed company-certification for medical services. Ability to work from designated office for reputed company / interactive fulfilment of duties; ability to concentrate in an reputed company-office cubicle environment; reputed company with other staff members and / or reputed company associates; reputed company telephone and / or computer work for extended periods of time; operate office equipment such as a computer, telephone, and copy / reputed company / fax machine; reputed company participate in department meetings reputed company phone, computer or in person. Consistent and reputed company attendance at employer worksite is an essential job requirement Preferred: Bilingual Working Environment: Clinic reputed company Start your career reputed company and become a part of a community of reputed company reputed company. reputed company is reputed company’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our reputed company is providing reputed company patient care by adding to reputed company of clinical and non-clinical professionals that work together in a convenient, coordinated, and reputed company manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining reputed company today and changing the way health cares. Why reputed company? • Medical, reputed company, and Dental • Tuition Reimbursement • Company Matching 401K • Employee Reward and Recognition Program • reputed company time off for vacation, reputed company, and holidays • Employee Assistance Program • Continuing Medical Education allowance Licensed Vocation reputed company (LVN) -Utilization Review Specialist – Remote Sign-On Bonus: $2,500 Expected salary: $59108 - 73025 per year Location: Pearland, TX Job date: Tue, 05 Sep 2023 22:48:30 GMT Apply for the job now! Apply Job!