Responsibilities
• Coordinate admissions to maintain optimal resident/guest census.
• Manage accurate and timely completion of admission documentation.
• Provide financial counseling to relevant teams and stakeholders.
• Conduct insurance verifications and communicate coinsurance amounts.
• Review insurance benefits and determine financial clearance eligibility.
• Coordinate non-contracted insurance agreements with Finance when necessary.
• Assess prior unpaid balances affecting admissions and communicate with relevant parties.
• Determine Medicaid eligibility and communicate cost-sharing requirements.
• Communicate admission approval or denial using designated software.
• Assist the facility during surveys, audits, government visits, and emergencies.
• Performs other duties as assigned or requested.
Qualifications and Requirements
• Prior experience in healthcare admissions, financial coordination, or insurance verification.
• Experience with Medicare and Medicare advantage plans.
• Strong understanding of insurance processes, including verification, eligibility, and benefits.
• Familiarity with healthcare regulations and compliance related to admissions and insurance.
• Clear and coherent in both verbal and written communication skills to effectively interact with various stakeholders, including patients, families, insurance providers, and internal teams.
• Ability to take patient calls to address inquiries related to admissions, insurance, and financial clearances – doing 10% of calls daily.
• Ability to accurately review and manage documentation to ensure financial clearances and compliance.
• Proficient in computer applications, including those used for insurance verification and admissions tracking.
• Ability to thrive in a fast-paced environment with the capacity to adapt swiftly to evolving situations while maintaining productivity and attention to detail.
• Possess strong listening skills to accurately comprehend verbal instructions and communications.
• Ability to transcribe spoken information effectively into written form for maintaining precise documentation and ensuring clear communication across various channels within the organization.
• Ability to understand and execute tasks based on verbal guidance, ensuring efficient workflow and task completion in alignment with organizational objectives.
• Strong interpersonal skills to build positive relationships with internal and external parties involved in the admissions process.
• Ability to identify and resolve issues related to insurance, financial clearance, and admissions.
• Ability to handle and maintain confidentiality given the sensitive nature of patient and insurance information.
