LPN Appeals Clerk

2 months ago

Rockville, United States Morgan Stephens Full time
Job Title: LPN Appeals Clerk (Managed Care/Medicaid Appeals)

Location: Remote (Occasional scheduled meetings in Rockville, MD)

Position Type: Contract to Permanent

Eligibility: Candidates must be located and licensed in Maryland

Pay Rate: $30/hour

About Us: Morgan Stephens is one of the top recruiting agencies in the USA, specializing in healthcare and small businesses. We are seeking a dedicated and experienced LPN Appeals Clerk to join our team, focusing on managed care and Medicaid appeals. This is a remote position with occasional scheduled meetings in Rockville, MD.

Job Description: The LPN Appeals Clerk will be responsible for managing the appeals process for managed care and Medicaid cases. The ideal candidate will have experience working with the elderly and in geriatric care, ensuring that appeals are handled efficiently and in compliance with all regulations and guidelines.

Key Responsibilities:
  • Review and process managed care and Medicaid appeals.
  • Gather and analyze medical records and other documentation to support appeal cases.
  • Communicate with healthcare providers, insurance companies, and patients to resolve appeals.
  • Prepare and submit appeal documentation within specified timelines.
  • Maintain accurate records of all appeals and related correspondence.
  • Participate in occasional scheduled meetings in Rockville, MD.
  • Ensure compliance with all relevant regulations and guidelines.
Qualifications:
  • Licensed Practical Nurse (LPN) with an active Maryland nursing license.
  • Experience in managed care and Medicaid appeals.
  • Strong understanding of geriatric care and the healthcare needs of the elderly.
  • Excellent communication and interpersonal skills.
  • Ability to work independently in a remote setting.
  • Detail-oriented with strong organizational skills.
  • Proficient in medical record review and documentation.
Preferred Qualifications:
  • Previous experience as an appeals clerk or in a similar role.
  • Familiarity with managed care organizations and Medicaid regulations.
  • Strong problem-solving skills and the ability to handle complex cases.
What We Offer:
  • Competitive pay rate of $30/hour.
  • Opportunity for contract to permanent employment.
  • Flexible remote work environment.
  • Professional growth and development opportunities.