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LVN Preauthorization Nurse Auditor- Galleria Area

Houston Galleria, TX

Posted: 07/25/2019 Industry: Office Administration Job Number: 143704.10 Pay Rate: $23-27/hr
Client in Galleria Area is seeking a LVN for a long term contract indefinite position paying $23-27/hr. based on experience
Job duties include:
-Works as part of integrated team and is involved in reviews of authorization requests and communicates with the physicians and clinic when additional information is needed or assists clinical practitioner
-Performs activities that include obtaining payer authorization for outpatient services that require notification/authorization based on payer specific guidelines.
-Responsible for clinical part of audit to determine if all charges have been captured appropriately.
-Maintains a thorough understanding of the plan's provider contracts and authorizations requirements
-Performs prior authorization and retrospective clinical review
Qualifications:
-licensed LVN in the state of Texas
-Minimum 6 months of utilization review, coding/billing, or authorization/case management experience required.
-Familiarity with hospital coding and billing processes preferred.
-Typing requirement 25 wpm

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