• Medical Management LPN - Coding Experience Needed

    Job Locations US-PA-Harrisburg
    ID
    2018-13033
    Category
    Akeso
    Facility
    Akeso Talent Engagement - Harrisburg, PA
    Type
    Contract
    Shift
    Days
  • Overview

    Licensed Practical Nurse, Medical Management

    Full-Time Contract Position for our Partner in Harrisburg, PA

     

    Akeso Talent Engagement has a need for a Licensed Practical Nurse to help support our Stop Loss Review group.  The role will involve performing clinical and risk management support to our underwriting and stop loss area for new/prospective business and renewal business quoting for stop loss products.  Key duties include reviewing high cost claimants (patients and outpatient), writing clinical summaries, and estimating future costs based on your clinical experience.

     

    Responsibilities

    • Review medical claim requests
    • Review and analyze high claimant rerpoting packages and external carrier reporting packages
    • Ongoing clinical review of high dollar claimants and Rx claims
    • Utilizing reports such as 50% threshold and breach reports
    • Development of case summaries including projected claims costs over the next 12 motnhs

    Qualifications

    • LPN License in the State of Pennsylvania
    • 5 years of professional clinical experience
    • Coding experience required
    • Proficient in MS Word and Excel
    • Proficient typing skills
    • Excellent communication skills!

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed