Registered Nurse, (RN),Coordinator Clinical Admissions-Mondays and as needed-Per Diem/Day(8Hr)

Location: 
SMMC-SMMC Hospital
Schedule: 
Per Diem
Shift: 
Day Job
Job Listing: 
SAD001999
Nurses

The Clinical Admission R.N. reviews all admissions on a daily basis to insure the patient class, accommodation code, Physician, diagnosis and service is correct. 

This position reviews the observation census log and contacts Case Management  for appropriateness of class when over 24 hours.  Coordinates special procedures.

 Reviews all cath lab and surgical procedures to insure accuracy of the data and admission order is in place.  Collaborates with HIM, Case Management and Patient Financial Services  to resolve discrepancies and insure accurate billing. 

Essential Job Outcomes Section II of the CAT. Specific job related responsibilities and duties. 1. Works collaboratively with Physicians, office staff and other departments. 2. Monitors ADT and census reports daily to ensure accuracy of information. 3. Communicates/coordinates with Coding, Case Mgmt., and PFS to ensure correct billing status and follow-up. 4. Reviews surgical cases for accuracy of diagnosis, procedure, patient class, insurance and order. 5. Coordinates special procedures; informs nursing unit, STAT R.N, Pharmacy, and Central Scheduling to ensure efficient patient flow. 6. Accepts calls from outside facilities/Case Mgmt.; obtains a bed and completes the bed reservation form in EPIC. 7. Monitors outpatient/observation census daily to ensure correct status. 8. Reviews Emergency Department admissions to ensure the order and patient class are accurate.

Qualifications: 

Graduate of an accredited RN School of Nursing. Minimum of three years acute care experience and 2- 3 years in utilization management or registration services required. In lieu of this experience, consideration will be made for staff with strong education and associated experiential background. Knowledge of current utilization management principles and criteria, third party payor guidelines, managed care models, reimbursement structures and the appeals process. Knowledge of various agencies and regulations pertaining to Milliman Care Guidelines (MCG), JCAHO, Medicare, Medi-cal, etc.

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