Admissions Coordinator

Description

TITLE: Admissions Coordinator

REPORTS TO: Director of Nursing

Non-Exempt

PURPOSE OF POSITION:

The Admissions Coordinator is responsible for oversight of all aspects of each resident's treatment plan from initial evaluation to discharge. The Coordinator is responsible for establishing and maintaining open, effective communication between the facility and referring publics, consumers, physicians, and third-party payers. This individual must be able to maintain a non-adversarial relationship with these referrers. The Coordinator provides maximum flexibility in coordinating the payer's needs with resident outcomes and prudent coos. This individual must be able to communicate effectively with the treatment team, as well as influence the treatment approach when needed. Market place feedback will be systematically provided to management and the treatment team, and utilized in the development of new or expanded services. As Social Services Director/Admissions Coordinator, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.

ROLE and RESPONSIBILITIES:

1. Identifies and maintains relationships with hospital discharge planners. Notifies of open beds. Fosters positive trust relationships with insurance representatives, referrers and physicians.
2. Receives referral from Physician, Hospital or Insurance based Coordinator on all transitional or sub-acute residents.
3. Conducts telephone and faxed copy assessment to ensure appropriate Clinical admission. May conduct an on-site evaluation if necessary.
4. Ensures initial and ongoing fiscal appropriateness of resident admissions to the facility. Determines resident Medicare, Managed Care and third-party insurance coverage for potential and newly admitted residents.
5. In conjunction with the Director of Nursing and Therapies, ensures the establishment of a treatment plan, which is timely, cost-effective and based on prioritized objectives.
6. Monitors resident's progress and communicates information between resident, referrer, family, insurance company and treatment team.
7. Coordinates daily/weekly interdisciplinary resident care conference for Managed Care residents.
8. Ensures development of discharge plan early in treatment programs with realistic discharge goals and destination.
9. Provides assertive consultation and input regarding program development and enhancements.
10. Obtains authorization for services from Managed Care as well as reauthorization and negotiates reimbursement.
11. Determines Resident medical eligibility, qualifying diagnosis, and determines Medicare/Managed Care eligibility based on skilled services provided.
12. Communicates with Managed Care authorization Case Managers, families and therapies regarding insurance coverage issues. Facilitate team meetings to review resident progress.
13. Supports nursing in care delivery and documentation and participates in care conferences, discharge conferences, wound care rounds, rehab rounds and utilization review of therapies.
14. Participates in internal moves/transfers and admission meeting.
15. Responds to inquiries from Hospital discharge planners related to possible admissions. Reviews assessment for appropriate facility placement within the continuum.
16. Facilitates the clinical needs of admitted residents by working with the interdisciplinary team at the facility.
17. Interview residents/guardians and obtain the required information and signatures.
18. Admit and prepare identification records for residents in accordance with established policies and procedures.
19. Admit, transfer, and discharge residents in accordance with established policies and procedures.
20. Obtain the resident/guardian's signature on all required permits; releases, authorizations, etc.
21. Maintain a current listing of all residents, their level of care, and assigned room numbers.
22. Provide copies of such listing to nursing service, administrative personnel, government agencies and personnel, etc. as necessary.
23. Collect, assemble, and check admission papers. Forward to the appropriate
24. Obtain the resident' assigned room number. Place on all necessary admission papers.
25. Explain to the resident, and/or guardian, room rates, billing procedures, visitors/guest privileges, restrictions, etc., as appropriate.
26. Refer admission problems to the proper authority, i.e., administrator, nursing service, etc.
27. Performs other duties and responsibilities in accordance with policies and procedures as directed and evaluated by the Facility Administrator.

KEY CHARACTERISTICS:

• Highly focused and strong attention to detail.
• Ability to work with frequent interruptions.
• Excellent communication skills written and oral.

EDUCATION/EXPERIENCE/QUALIFICATIONS:

1. Must be a Registered Nurse in accordance with the laws of the State of Georgia
2. 5 years' experience in long term care or more is preferred.
3. Good working knowledge of Medicare, Managed Care and other 3rd party payers' clinical and financial guidelines. Working knowledge and experience with long term care admissions and discharge procedures.
4. Must have a working knowledge of medical terminology. Must be able to deal respectfully with staff, residents, visitors and other health care providers.
5. Must have a working knowledge of computers and automated health care information systems.

---