Prior Authorization Licensed Practical Nurse
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At a glance
Requirements
Credentials this posting asks for.
Job overview
US Tech Solutions is hiring a Prior Authorization Licensed Practical Nurse. The remote Prior Authorization Licensed Practical Nurse role at US Tech Solutions supports a HIPAA‑compliant work‑from‑home environment, handling inbound calls, case processing, and electronic authorizations while maintaining accurate documentation and data management. The nurse collaborates with pharmacists, clinical colleagues, and members, providing on‑call support and mentoring within the prior‑authorization team.
Key focus areas include Answer inbound phone calls with courteous and professional behavior., Process cases and electronic authorizations., and Load authorizations into the system..
Important skills include HIPAA Compliant Workspace, Secure Internet 25Mbps+, Provide Screenshot Of Speed, Excellent Verbal Communication, Excellent Written Communication, and On-Call Availability.
Skills & qualifications
Skills
Qualifications
Full job description
Please note: Actual location may vary., RI
Contract
Job Summary:
This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area away from distractions, and must have their own secure private internet services of at least 25mbps download/3mbps upload in order to ensure sufficient speed to adequately perform work duties. Must provide a screenshot of internet speeds with resume and provide license number.
Responsibilities:
Responsibilities include answering inbound phone calls, processing cases and electronic authorizations, loading authorizations, and making follow-up phone calls utilizing appropriate courteous and professional behavior based upon established standards. Maintaining complete and accurate, documentation of all necessary information is necessary and will involve computer system data entry, data management, and reporting.
Experience:
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∙ Review criteria-based prior authorizations following policy and procedure.
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∙ Provide on-call after hours nurse availability for urgent PA requests.
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∙ Provide internal nurse support to the PA team and member services department .
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∙ Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).
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∙ Shift priorities while exhibiting a high level of urgency with all calls and assignments.
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∙ Excellent verbal and written skills.
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∙ You will work with pharmacists, other clinical colleagues, healthcare professionals and members.
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∙ Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
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∙ Train and mentor representatives on the PA team.
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∙ Complete other PA assignments as delegated by the PA leadership team.
Education:
The Licensed Practical Nurse is a graduate of a school of Practical or Vocational Nursing, approved by the State Agency and/or accredited by the National League for Nursing (Accrediting Commission (NLNAC)) at the time the program was completed by the applicant.
Skills:
LPN, Prior auth
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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