LVN Lead Clinical Appeals Nurse

We are looking for an experienced and passionate LVN Lead Clinical Appeals Nurse to join the Molina Healthcare team. In this role, you will have the opportunity to be a part of a dedicated team of professionals that is committed to providing quality healthcare for our members. The ideal candidate will be experienced in healthcare appeals management, possess excellent communication skills, and be a team player. If you are looking to join an innovative and progressive organization that is focused on improving the lives of our members, we want to hear from you!Required Qualifications:• Current, unrestricted LVN license in the state of California • At least 5 years of experience in healthcare appeals management• Proven track record of achieving successful appeals outcomes• Experience with managed care and/or government funded programs• Ability to communicate effectively and work collaboratively with staff and other healthcare providers• Ability to multitask and remain organized in a fast-paced environment• Knowledge of medical terminology and coding• Strong computer skills, including experience with Microsoft Office and EMR software

Responsibilities:

1. Manage healthcare appeals process for Molina Healthcare members.
2. Communicate effectively with staff and other healthcare providers.
3. Accurately document appeals outcomes in EMR software.
4. Maintain current, unrestricted LVN license in the state of California.
5. Utilize knowledge of medical terminology and coding to accurately process appeals.
6. Remain organized and multitask in a fast-paced environment.
7. Utilize strong computer skills, including experience with Microsoft Office.
8. Collaborate with staff and other healthcare providers to ensure successful appeals outcomes.
9. Stay up-to-date with healthcare regulations and guidelines.
10. Provide guidance and training to other staff members on appeals management.

According to JobzMall, the average salary range for a LVN Lead Clinical Appeals Nurse is $54,000 to $92,000 per year. This range can vary depending on the state, experience, and certifications of the individual. The job responsibilities of a LVN Lead Clinical Appeals Nurse include monitoring incoming appeals, ensuring compliance with state and federal regulations, and resolving any appeals that require further review. They must also manage and coordinate the appeals process with other departments, maintain records and reports

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.