Job Description

Job Summary:

Performs Admission review, Concurrent Management and Discharge planning of customers who admitted in network hospitals.

Key Responsibilities:

  • Prioritizes and plans workload to meet or exceed TAT and productivity
  • Daily reviews admission notification to determine indication for admission, escalate to level 2 if necessary
  • Contact hospital UR nurse to obtain medical record and necessary information
  • Scheduling concurrent telephonic reviews in advance to efficiently manage
  • Recommend discharge planning as soon as the patient’s condition can be treated as OPD and follow up closely
  • Perform accurate and clear data entry in claims system
  • Escalate case to claim relation for specific condition align with department direction
  • Perform daily report 
  • Perform other duties as assigned

Job Requirements:

  • Bachelor’s degree in nursing
  • 3 - 5 years medical/surgical nursing experience
  • Computer skills for MS Word and Excel
  • Available to work on weekend and holiday


Job Segment: Manager, Data Entry, Management, Administrative


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