Prior Authorization Nurse

Providing essential support in the processing and communication of Commercial Prior Authorizations, the part-time contract Oklahoma Licensed Prior Authorization LPN will manage inbound calls, oversee fax processing, and assist prescriber office staff while working remotely.

Key responsibilities:

Answer inbound phone calls and process prior authorization cases, including follow-up communications Maintain accurate documentation and data entry for all prior authorization activities Review prior authorizations and appeals based on clinical criteria and refer cases as necessary

Required qualifications:

Active, unrestricted LPN/LVN license Minimum of 2+ years of recent prior authorization experience in a PBM, MDO, or clinical setting Experience reviewing and applying clinical criteria for prior authorizations Familiarity with authorization platforms such as Cover My Meds  Licensed as an LPN in the state of residence