Admissions Manager
1 month ago
POSITION SUMMARY:
Under the direct supervision of the Corporate Director, Revenue Cycle, the Manager, Admissions drives a Admissions Team towards exceptional performance. Having financial and operational accountability over Nexus Health Systems patient admissions, the Manager, Admissions provides leadership to the Admissions Department operations such as, but not limited to, referral management, patient census, payer-specific admission criteria, authorization denial management, and data analysis. More so, the Manager, Admissions provides on-going leadership to day-to-day operations, supporting his/her team as opportunities presents, as well as collaborating across the health system in effort to meet organizational objectives.
JOB SPECIFIC RESPONSIBILITIES:
A model employee of GOPTIC values
Fosters a learning environment
Maintain utmost level of confidentiality at all times
Adhere to health system policies and procedures
Demonstrate business practices and personal actions that are ethical, and adhere to corporate compliance and integrity guidelines
Maintains a sense of professional and self-validation
Ability to communicate effectively with all stakeholders across the health system
Embodies a team player persona, and illustrate team payer dynamics to support a strong Admissions Team
Responsible for promoting adherence to applicable State/Federal laws and regulations and the program requirements of accreditation agencies and Federal/State and private health plans in requests for third party authorizations
Providers leadership to an Admissions Team
Drives the admission process for Nexus Health Systems (NHS) in efforts to meet census goals
Ensures Admission Coordinators are completing all referral tasks timely and accurately
Establishes priorities and functional standards for the Admissions Department
Exercises good judgment when addressing and resolving issues
Meets or exceeds monthly census goals for the Admissions Department
Manages the day-to-day admission area operations and immediate questions or concerns
Leads overall admission flow, and addressing unusual occurrences, circumstances, or discrepancies to admissions workflow
Leads the discovery of root cause authorization denials and implement denial management strategies for denial prevention
Provides leadership to on-going quality assurance audits in conjunction with departmental policies, ensuring the Admissions Team is exercising operational objectives
Oversight to aging referral requests, escalating referral request as needed for timely decision making
Oversight to operations to identify problematic activity impacting referral aging, authorization denials, and referral close-outs for the Admissions Department
Oversight to telephone calls, ensuring calls are handled with exceptional Customer Service, and are escalated to leadership as needed
Develops short-term and long-term strategies to meet or exceed departmental and organizational KPI’s,
Recommends and/or implement process improvements with proven and effective data analysis
Exemplify excellent Customer Service in communicating internally/externally to stakeholders in efforts to obtain necessary documentation for in-coming referrals
Oversight to referral authorization requests to prevent timely filing denials
Oversight to documentation of referrals and authorization, and provides leadership to the appropriate actions on in-coming referrals
Mandatory to drive a reduction in referral aging, while working collaborative with stakeholders acorss the health system to render decisions on in-coming referrals
Participates and/or leads departmental meetings, while fostering an environment of teamwork and collaboration
Serves as a subject matter expert for the Admissions Department to executive leadership
Consults with patients and/or guardians to discuss financial obligations, and presents payment options for self-pay portions
Immediately informs stakeholders of significant operational issues, such as, funding, authorization denials, payer requirements
Oversight to personnel needs, such as, but not limited to bonus payouts, call-ins, PTO requests, hiring, disciplinary actions, termination
Develops, adhere, and maintains departmental policies and procedures as necessary to support departmental goals
Develops departmental reports, and routinely distributes to stakeholders as needed
Performs other duties as assigned.
POSITION QUALIFICATIONS:
EDUCATION:
Bachelor’s Degree preferred, or minimal two years of relevant work experience
EXPERIENCE:
Two (2) years of healthcare experience, within a Revenue Cycle setting
LICENSURE/CERTIFICATION:
Certified Revenue Cycle Representative (CRCR), preferred
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