LVN Referral Coordinator

The LVN Referral Coordinator facilitates and complies with Utilization Management plan, policies and procedures, referral authorizations, denials, and appeals, custodial, ESRD, transplants and out of area for the assigned medical group, IPA’s and/or other assigned entities. Supports and assists the UM Department. Travel required. Skills, Knowledge and Abilities:Possess planning, organizing, conflict resolution, negotiating, and essential interpersonal skills. Follow through with problem identification/resolution originated by supervisory staff for regarding assigned group’s patients or providers. Proficient in PC software computer skills. Must have sound knowledge of managed care, medical terminology, referral process, claims, and ICD-9 and CPT coding. Requires basic knowledge of UM processes to ensure compliance and oversight of process of physician groups and coworkers. Excellent verbal and written skills. Ability to interact productively with individuals and with multidisciplinary teams.  Experience:Previous experience in Physician Office as Medical Assistant or LVN preferred. Minimum two years experience in managed care with either referral processing or claims processing experience preferred. Education:High School Diploma.Licensure from an applied vocational or academic curriculum with an approved Licensed Vocational Nurse program.