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 requirementsHome Health and/or Hospice is STRONGLY preferred as this will help you with the regulations

 

We value the unique skills of veterans and military spouses. We encourage applications from military veterans and their families.

Elara Caring provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex (including pregnancy, childbirth or related medical conditions), race, color, age (40 and older), national origin, religion, disability, genetic information, marital status, sexual orientation, gender identity, gender reassignment, protected veteran status, or any other basis prohibited under applicable federal, state or local law. 

Elara Caring participates in E-Verify and we will provide the Federal Government with your Form I-9 information to confirm that you are authorized to work in the United States. Employers like Elara Caring can only use E-Verify once you have accepted the job offer and completed the Form I-9.

At Elara Caring, pay and compensation are determined by a variety of factors, including education, job-related knowledge, skills, training, and experience. Our compensation structure reflects the cost of labor across different U.S. geographic markets, and may vary based on location.

This is not a comprehensive list of all job responsibilities and requirements; upon request, a job description can be provided.

If you are an individual with a disability and are unable or limited in your ability to use or access our career site as a result of your disability, you may request reasonable accommodations by reaching out to recruiting@elara.com.