101 Best appeals nurse Jobs in Vestal, New York (September 2025)

Guthrie

LPN Care Coordinator - Hereditary Risk Program - Full Time

9 days ago

Binghamton

Job Description Eligible for up to $15,000.00 Sign on Bonus for those that qualify Monday through Friday 8:00am-4:30pm Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient messages, in basket monitoring, overdue results, referrals, provider orders and support the nurse navigator role. Experience: A minimum of 2 years’ experience preferred in nursing, possess a functional knowledge of cancer diagnosis and treatment, and demonstrate the ability to work collaboratively with a multidisciplinary team to educate and coordinate care for patients. Education: Must possess a valid Licensed Practical Nursing license in the state in which the position resides. Licenses: Licensed Practical Nurse in the state of position. Essential Functions: Patient Calls Incoming and Outgoing • Sick calls - collect data for review, assessment and instruction from RN or Provider, • Results – provide results and any follow up needed per provider instruction, • Lab Orders and Imaging – Overdue testing, newly ordered by provider, importance of ordered testing. Coordinating scheduling and follow up as needed Medication refill Requests • Review medication refill requests for appointment compliance, correctness and time frames. Provide collected information for providers to review and authorize requests, • Obtain clarification as needed from providers for pharmacy to facilitate safe and timely dispensing of the medication for the patient as needed Medication Prior Authorization • Collect necessary documentation and submit it to the patient's insurance company for review and determination of coverage of ordered medications, • Coordinate and complete appeals for denials as needed, • Monitor and Review REMS clearance for monthly refills of high-risk medications ordered for patients Monitor and Manage Department in Basket • E-Guthrie Medical Advice Requests, • Medication Cancellation notifications, • Electronic Refill Requests, • System generated Medication Authorization Request, • Staff Messages, • Provider In basket - when a provider has departed or if they are out of the office for extended period and facilitate forwarding results to other providers for review and direction Overdue Results • Lab orders review for continued need or duplication. Assure follow up appointments are scheduled, and labs are extended appropriately to co-inside with the follow up to assure patient return to compliance, • Imaging orders review for continued need or duplication. Extend scheduled testing orders as needed, Schedule testing with patient and explain importance of ordered testing under the direction of the providers orders to sure patient return to compliance Referrals • Coordinate per provider request with other oncology specialty services as needed Provider Orders • Monitor Provider schedule for requested lab orders needed for follow up, assure they have been ordered and if not add verbal orders linking to appropriate diagnosis and sign. Provider later co-signs orders, • Assist CA in office with Pre-visit planning and lab order needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and guidance of the RN Navigator. Records release – As requested by collaborative care offices and for DBL office as needed Coverage for RN Nurse Navigator • Coordinate and facilitate completion of the RN Navigators messages, calls and requests with the appropriate individuals to assure there are no delays in patient care while they are not in the office LPN Clinical Care • Dressing changes, injections, rooming and patient care as directed while in the office under the instruction of the RN and Providers, • Duties requested and needed under the scope of the NYS LPN License Other Duties: Other duties as assigned. Pay Range $25.59-$36.59/hr DOE About Us Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you’ll find staff members who have committed themselves to serving the community. The Guthrie Clinic is an Equal Opportunity Employer. The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.

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