What does a Patient Benefit and Care Nurse Coordinator I Do?
The Patient Benefit and Care Nurse Coordinator I assesses medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and monitors compliance with established guidelines. Coordinates with care providers and plan members with the goal of maximizing member benefits while managing costs. Being a Patient Benefit and Care Nurse Coordinator I interprets benefits and guides members to choose to the appropriate providers, projects and resources. Assists members in appeals for denied services. In addition, Patient Benefit and Care Nurse Coordinator I typically requir ...es a special degree of Nursing or its equivalent. Typically reports to a manager. Requires RN license. Working as a Patient Benefit and Care Nurse Coordinator I typically requires 3-5 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work.More Show Less
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