Risk Anti-Fraud Support LPN - PT 100% Remote

100% remote position. We encourage you to apply if you live in the following states

• AZ, FL, GA, ME, MA, NH, MD, NC, SC, TN, VA

FedPoint, previously doing business as LTC Partners, was founded in 2002 and is a versatile administrator of large-scale insurance and benefits programs. We are hiring a Clinical Risk Anti-Fraud Support Licensed Practical Nurse to join our Care Coordination team! This is an exciting role working in a 400-person company with big aspirations, and a wonderful culture.

For this part-time role (20 hours per week), we are offering a fully remote schedule. The ideal candidate would be able to work Monday - Friday 4 hours per day (possibly 10am-2pm to be able to accommodate clients in west coast.) - some flexibility possible. Full time hours are available for the training period.

As the Risk Anti-Fraud Support LPN, you will assist the RN Risk Specialist in the primary areas of operation for Fraud, Waste, Abuse, the Claims Appeals program, claims reconsideration processes and program contestability.

This Clinical role will also collaborate with our RN Risk specialist to ensure needs are met using the current services designated on the plan of care and educating the enrollee about both the Federal Long Term Care Insurance Plan design and methods of conserving their lifetime benefit is an ongoing responsibility, including provision of discounts for services when available.

Requirements:

• Must reside in the following states: AZ, FL, GA, ME, MA, NH, MD, NC, SC, TN, VA


• Licensed Practical Nurse with up to 2 years' experience in a variety of medical settings, preferably in long term care or home health settings


• Excellent assessment skills and professional judgment


• Excellent verbal and written skills


• Ability to work independently with minimal supervision


• Flexible with ability to handle multiple tasks and screens simultaneously


• Good telephone skills - previous telephonic experience a plus


• Basic computer skills with MS Office Suite.


• Completion of the AHIP Long Term Care courses within 3 years of employment


• Required to uphold the principles of compliance and fraud management as outlined by corporate and departmental policies. Supports and participates in the mandatory training on an annual or more frequent basis, as required


• Experience in Case Management preferred


• Experience in fraud, waste and abuse preferred