Admissions Services Specialist Acute-PRN

Essential Functions

• Manage Referral Management Portals
• Maintain oversight of all faxed referrals
• Maintain oversight of all webforms and call center handoffs/rollover referrals
• Utilize facility admissions/exclusionary criteria to process incoming types of referrals
• Respond to inquiries about the facility within facility policy timeframes
• Document calls inside of Salesforce and follow-up as needed
• Complete Prior Authorization
• Pre-Admit the patients in billing system
• Cook up admission coordination with local admissions department regarding bed availability
• Facilitate intake, admissions, and utilization review process for incoming patients
• Perform insurance benefit verifications, disseminating the information to appropriate internal staff
• Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals
• Coordinate admission and transfer between levels of care within the facility
• Communicate projected admissions to designated internal representative in a timely manner
• Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission

Standard Expectations

• Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality
• Communicates clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team

Education/Experience/Skill Requirements

• Bachelor’s or Master’s degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN
• Knowledge of admission/referral processes, techniques, and tools
• Solid understanding of financial principles and insurance reimbursement practices
• Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application

Licenses/Designations/Certifications

• Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates

Supervisory Requirements

This position is an Individual Contributor