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Clinic Coordinator (gynecology) in Troy at Collabera

Date Posted: 9/7/2018

Job Snapshot

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Job Description

• Review clinical for requests for inpatient admissions, using InterQual to determine if criteria are met.
• Triage obstetrical deliveries, gynecological procedures and newborn admissions from various resources into UM database within a specific time frame.
• Enter cases for neonatal intensive care infants and other inpatient admissions, gathering necessary coding and clinical information for nurse review.
• Investigate member eligibility, benefit availability, provider contract and COB status.
• Collect discharge information on pending cases, approve in accordance to state mandates.

Job Requirements

Required Licensure: Active nursing license; RN
Required Education: Bachelor in Science in Nursing
Minimum years of experience: 5 years as a nurse with utilization management or utilization review experience.