Hospital Admitting Nurse

Minimum four years prior related experience. To include at least two years’ experience in nursing or one-year related nursing experience in utilization review/insurance/case management/medical clearance.
Graduation from an accredited school of nursing.
Current State of California Professional Nursing License (RN)
Ability to read and comprehend English.
Computer/basic keyboard skills, telephone skills, and general knowledge of office machines including printers, fax, copier, scanner, and credit card machines required.
Current BLS certification from American Heart Association OR ability to obtain within 90 days of start.

Facilitate patient medical and financial clearance using nursing knowledge, clinical judgment, and communication skills.
Consistently and accurately utilize medical acceptance criteria to screen Emergency Room patients.
Perform clinical review of all inpatients to determine medical acceptance following the Miliman guidelines and communicate with patients and physicians who fail to meet medical criteria for acceptance.
Use excellent oral communication and listening skills to communicate with patients, physicians, and clinical staff regarding obstacles to access or financial clearance.
Respond to voicemails within one business day and answer phone calls in a timely manner.
Completely and accurately document communications with payors, patients, and the treatment team.

Two years’ experience in utilization review with external payors within a hospital or insurance setting.
Highly organized with strong communication skills, oral and written.
Confidence to communicate and outreach to other community health care organizations and personnel.
Demonstrates sound judgment, decision making and problem-solving skills.
Ability to apply principles of process improvement.
Must be able to follow detailed instructions and perform repetitious tasks.
Bachelor of Science in Nursing (BSN).