This position serves as the facility Admissions Coordinator and responsible for converting referrals into actual admissions by managing all referrals from the time of referral to the time of actual admission.
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- Effectively converts appropriate inpatient referrals into admissions within timeframes identified by referral sources.
- Ensures that insurance verifications are completed for potential inpatient admissions to the facility.
- Establishes and maintains effective working relationships with referral sources.
- Completes Intake Form accurately and completely, obtaining all pertinent financial and personal information on all referrals.
- Completes benefits explanation documentation for pt/family.
- Assures timely completion of screening for all referrals and relays timeframes to referral source and all related parties throughout the admissions process.
- Obtains and documents clinical and financial acceptance from appropriate administrative staff for all referrals within established time frames and communicates to referral source and all related parties.
- Secures a rate from CEO or designee, if necessary, for commercial payors. Facilities care plan and/or additional communication from facility case manager to the payor as necessary.
- Coordinates all incoming transfers.
- Documents all interactions by date and time relative to each referral.
- Completes and submits daily and monthly logs and reports.
- Enters data into the patient accounting system as needed.
- Attends all scheduled marketing meetings, as requested.
- Completes follow-up phone calls on canceled referrals on a monthly/quarterly basis.
- Liaison with Texas Department of Assistive and Rehabilitative Services for potential inpatient/outpatient referrals.
- Providing monthly referral, admission, and discharge tracking report(s) to the CEO and members of the marketing team.
- Markets facility programs and services to potential referral sources and conducts tours of the facility to potential referral sources and family members
- Participates in daily flash meetings with CEO and/or key department managers or their designee to discuss referral activities.
- Updates daily referral activity and faxes intake board to CEO and/or designees: per protocol.
- Documents all conversations and completes intake checklist for each referral.
- Demonstrates knowledge and awareness of Licensing regulations and third-party payer information.
- Performs the above duties/responsibilities in both the inpatient setting and outpatient clinic setting.
- Performs other duties as assigned.
- Experience in case management and insurance verification.
- Strong background in healthcare with knowledge of Medicare, Medicaid, and commercial insurance preferred.
- Microsoft efficient
- Medical terminology and demonstrated organizational skills necessary.
- High school diploma or equivalent
- Preferably some college courses
All Nexus Health Systems employees will need to meet the requirements outlined in the Centers for Medicare & Medicaid Services (CMS) interim final rule requiring all workers in most health care settings that participate in the Medicare and Medicaid programs to be fully vaccinated against COVID-19. The rule is effective November 5, 2021. Under the regulation, all eligible workers of Nexus Health Systems must be fully vaccinated by January 4, 2022.