LPN /LVN Medical Reviewer- Remote

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place.

Job Description:

LPN Medical Reviewer

At Elara Caring, we care where you are—and believe the best place for care is where our patients live. That’s why we provide high-quality, compassionate care to more than 60,000 patients every day in their preferred home setting. As a Medical Reviewer, you play a vital role in supporting our mission by ensuring clinical and billing compliance through meticulous review and documentation processes.

Schedule: Monday – Friday (40 hours)

The Medical Reviewer is responsible for collecting, reviewing, and analyzing medical records and claims to ensure billing compliance and determine benefit coverage for services under review. You will prepare detailed reports of your findings and submit them to payers as required. This role demands strong attention to detail, a deep understanding of clinical documentation, and strong computer skills to manage electronic records and workflows efficiently.

Key Responsibilities:

• Retrieve and organize appropriate medical records for review.
• Conduct medical record reviews to ensure accuracy, completeness, and compliance with billing and coding standards.
• Analyze submitted and pending claims to assess benefit coverage.
• Prepare clear, well-documented written reports outlining review outcomes.
• Submit documentation to payers accurately and timely.
• Collaborate with clinical and billing teams as needed to clarify information or resolve discrepancies.
• Maintain up-to-date knowledge of Medicare, Medicaid, and third-party payer regulations.

Why Join Elara Caring?

• Work in a collaborative, mission-driven environment.
• Competitive compensation package.
• Tuition reimbursement for full-time staff and no-cost continuing education opportunities for all employees.
• Comprehensive medical, dental, and vision insurance plans.
• 401(K) with employer match.
• Paid time off, holidays, and family/pet bereavement leave.
• Pet insurance.
• Opportunities for professional growth and advancement.

What You Bring:

• Graduate of an accredited LPN or LVN program; current LPN or LVN license required.
• Minimum of 3 years’ clinical experience in home health and/or hospice care.
• Prior experience in medical review, utilization review, or case management preferred.
• Solid understanding of medical billing, coding guidelines, and payer requirements.
• Excellent organizational, critical thinking, and communication skills.
• Strong computer skills and comfort working with electronic medical records and related software platforms.
• Ability to stay current with evolving healthcare regulations and payer requirements