We have a great opening with our client Harris Health System for 5 Licensed Vocational Nurses Nurse Auditor experience. Please see below for the details and advise if you are interested:
LVN Pre/Authorization Nurse Auditor ( Job Details)
- Work Schedule : 8am to 4:30 pm or 8:30 am to 5:00pm
- Location: 610 South area in Houston, Tx
- Pay rate: $22.14 an hour - $25.55 an depending on years of work experience
Harris Health Systems works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HHS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
Obtains authorizations for scheduled outpatient appointments, special procedures, tests, injections and higher level services.
Evaluates the medical necessity for inpatient hospital admission and Outpatient appointments reviews the authorization of the services or admission along with the estimated length of stay utilizing nationally recognized screening criteria.
Identifies issues that are impacting initial, continued stay, high level service and outpatient service authorizations.
Participates in monthly departmental payer Provider Representative meetings.
Maintains all authorization information on the Auth/Cert screens in EPIC. Information is to be specific enough to assist in the tracking and managing of denials.
Interacts with all levels of clinical and administrative staff when addressing issues impacting inpatient denials.
Logs and maintains all denials on the Nurse Audit Log by recording the specific data associated by the data fields.
- Handles all other special projects for Manager, or Director of Operations of Patient Financial Services as requested such as representing her in internal and external meetings.
- Ensures that the employees of the department have current up-to-date policies and procedures that will assist them in meeting their goals.
- Ensures that the team members are responsible for assisting co-workers during heavy workloads and that they utilize their free time to complete tasks necessary to meet departmental/Harris Health System needs.
- Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program
- 1-3 years of hospital or medical clinic experience.
Required License, Certification, Association: Active - Licensed Vocational Nurse (LVN) or LPN
We are a local staffing agency serving Houston's major government entities. We can give you access to temp-to-hire opportunities! Whether you are a job seeker or a company looking for a Houston-area staffing agency, we can meet your needs. We take all the necessary steps to properly assess our applicant's talents so that we are sure they will be uniquely suited for their assignments. We go to great lengths to understand our clients' staffing needs so they get the most qualified candidates. Our stellar customer service, tireless work ethic and a strong commitment to excellence make A-1 Personnel the right staffing agency for you!
Please apply online. #removed#
Role: LVN Nurse Auditor
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