LPN / Medical Reviewer / Remote Job at InGenesis, Inc., Columbia, SC

RXBOam9WQWxXR1RiSUUzTWJzYlJBV1ZwZHc9PQ==
  • InGenesis, Inc.
  • Columbia, SC

Job Description

InGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our client located in Columbia, SC. In this role, you will perform Medical Review of clinical information using established criteria or clinical guidelines. In this role, you will provide support and review of medical claims and utilization practices.

This is a REMOTE opportunity for a LPN living in the state of South Carolina . Apply today and we’ll reach out to answer any questions you may have!

Job Duties

  • Responsible for supporting and maintaining the coordination of daily operations of assigned area.
  • Interfaces with the medical management on a regular basis to work more complex UR cases for the outpatient UR function
  • Maintains the outpatient authorization process to include ensuring benefit coverage, reviewing/determining eligibility, reviewing of established UR criteria, interpreting rules and regulations.
  • Completes authorization by following established policies
  • Review interdepartmental requests and medical information to complete utilization process
  • Documents process used and decision int he appropriate system in accurate and timely manner.
  • Performed other duties as assigned.

Minimum Qualifications

  • Current Licensed Practical Nurse / LPN license in the State of South Carolina or active compact multistate unrestricted LPN license
  • 3+ years managed care or physician's office experience
  • Computer proficiency

EEO Statement

InGenesis is an equal opportunity employer committed to fostering a diverse, inclusive, and equitable workplace. We comply with all applicable federal, state, and local employment laws, including recent executive orders, and strictly prohibit discrimination, harassment, or retaliation based on race, color, religion, sex, sexual orientation, gender identity, national origin, disability, genetic information, age, veteran status, or any other characteristic protected by law.

InGenesis is dedicated to making reasonable accommodations for qualified individuals with disabilities and ensuring that all employment decisions are based on qualifications, merit, and business needs. If you require a reasonable accommodation during the hiring process, please contact us by visiting our website at

To learn more about your rights, please refer to the Know Your Rights: Workplace Discrimination is Illegal poster issued by the U.S. Equal Employment Opportunity Commission (EEOC).

Company Statement

With decades of experience, InGenesis has grown into one of North America’s most trusted Healthcare Services Firms, which includes comprehensive health and workforce solutions. As the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. Explore InGenesis to discover how our expertise, innovative strategies, and commitment to excellence are shaping the future of healthcare workforce solutions. Join us in celebrating the professionals who define the next era of healthcare.

Job Tags

Work at office, Local area, Remote work, Shift work,

Similar Jobs

SeekTeachers

Physical Education Teacher Job at SeekTeachers

Description Physical Education Teacher SeekTeacher is looking for Physical Teacher to join a well established international school in Dasman, kuwait is renowned for its academic excellence. The school's grounds boast incredible facilities... 

Reyes Holdings

Merchandiser Job at Reyes Holdings

Join the leading beverage provider, Reyes Coca-Cola Bottling! + Shift: Full Time, Weekend Availability Required, 5AM Start time + Benefits: Medical, Dental, Vision, Retirement, PTO + Local Routes available: Orange and surrounding areas + Hourly Pay Rate: $23.50 plus...

PwC

Financial Markets & Real Estate - Accounting Advisory, Senior Associate Job at PwC

 ...you need to lead and deliver value at this level include but are not limited to:+ Respond...  ...CPA License, Level 3 of the CFA, JD, PhD, MBA or Master's degree in Finance, Tax, Quantitative...  ...does not intend to hire experienced or entry level job seekers who will need, now or in... 

Dayspring Fellowship

Pastor of Children's Ministries Job at Dayspring Fellowship

The Pastor of Children's Ministries is responsible for discipling the next generation of Christ-followers by providing leadership in planning, conducting, and evaluating a Christ-centered program for children ages birth through 5th grade. The PCM should be someone who... 

Marquette Management

Property Accountant Job at Marquette Management

 ...Immediately!!!!Marquette Management, Inc. www.marquettemanagement.com one of the nations most innovative property management companies, is seeking out an experienced accountant in Crest Hill, IL. Duties include A/R, A/P, Bank Recs, F/S prep and strong computer skills....