LPN Care Coordinator - Hospital Services and Medications (Las Vegas)

WHAT IT TAKES TO BE PART OF OUR TEAM

Are you an exceptional LPN Care Coordinator who absolutely thrives on being part of an accountable team? Can you dedicate yourself to being part of a team serving the needs of children and their families? Do you bring the highest standards of integrity and professionalism to your team? Do you thrive in an environment where you are valued and appreciated for who you are, how hard you work and for that something special you bring to the teams you choose to work with? Are you looking for an organization that offers competitive compensation and one of the broadest and most comprehensive benefit packages available in the field of healthcare?

This is a role that requires a multi-disciplinary team approach to solving problems and patient challenges. We frown upon elitists who often use the phrase "that's not my job" or "someone else can do it". The primary goal is to bring the best patient care and experience for our area's sickest children, not about feeding anyone's ego.

SUMMARY:
LPN Care Coordinator ? Hospital Services and Medications are responsible for processing referrals and obtaining prior authorizations for hospital services/admissions and in-office administered medications, dispense medications, and prescription medications. Perform complex clerical procedures related to obtaining prior authorizations to ensure patients receive coverage for the specific services and/or medications prescribed for treatment. Provide prompt, courteous customer service to patients and providers. This is a non-exempt position that reports directly to the Chief Financial Officer.

ESSENTIAL DUTIES AND RESPONSIBILITIES

LPN Care Coordinator duties typically include but are not limited to the following:

a) Utilize clinical data/knowledge to assist patients in gaining appropriate physician, hospital, medical group and community referrals.
b) Utilize computer software to process referrals and maintain up-to-date databases.
c) Facilitates scheduling of appointments and services.
d) Obtain prior authorizations for in-office infusions, including related medications, and in/out-patient hospital procedures/services including chemo administration, transfusions and other hospitalizations ordered by practice providers. Payer authorization tools including forms, websites and telephone or fax lines will be used to obtain related authorizations.
e) Obtain prior authorization for prescriptions including specialty medications.
f) Read and understand chemotherapy roadmaps and physician orders for purpose of obtaining authorization for ordered services.
g) Research and provide supporting documentation to appropriately appeal denials of physician ordered services.
h) Support Authorization and Referrals Specialists with appeals for denials of physician ordered services including in-office infusions, hospital services, prescriptions and imaging or other procedures.
i) Coordination with other members of the clinic or hospital regarding patient infusions and hospital services.
j) Maintains current patient files updated with the most current patient insurance coverage provided.
k) Monitors department voice mail, Qliq, email, Teams messages and processes prior authorization requests in accordance with departmental guidelines.
l) Maintains telephone service standards and returns patient messages within one (1) business day.
m) Act as a point of contact for assigned providers to answer and route questions about patient care.
n) Attend weekly provider meetings.
o) Perform routine administrative and clerical tasks to keep the offices of physicians and other health practitioners running smoothly including answering telephones, communicating with patients, and communicating with physicians.
p) Administrative duties may include but are not limited to the following:

  • Answers telephones; taking complete and accurate messages
  • Fill out insurance forms
  • Handle correspondence
  • Schedule appointments
  • Arranges for ancillary services
  • Arrange hospital services, inpatient and outpatient
  • Collection of medical records
  • Review and collection of physician orders
  • Performs other administrative duties as directed

Interested in Applying?

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